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Cluster A personality disorders and potential for early intervention in psychosis: Challenges and opportunities

Farooq, Saeed; Ayub, Muhammad


Muhammad Ayub


The ‘Cluster A’ personality disorders consist of paranoid, schizoid and schizotypal personality disorders. The common features of personality disorders in this cluster are social awkwardness, social withdrawal, odd or eccentric behaviour and distorted thinking. These personality disorders, especially schizotypal and schizoid PD have a long history that is deeply rooted in the concept of schizotypy. The personality disorders in cluster A are relatively common and are responsible for high burden of disease, disability and can potentially be precursors to schizophrenia. However, the research in psychopathology, aetiology and treatment of these disorders lagged behind in comparison to other personality disorders such as borderline PD. The guidelines for treatment of these personality disorders are practically non-existent. On the other hand, a lot of research efforts in the last two decades had focused on clinically high-risk states for psychosis but these concepts had little clinical influence beyond the highly specialized research and early intervention services. We feel that a major research effort is needed to bridge the gap between the cluster A personality disorders and recently emerging high-risk states for psychosis. In this chapter, we provide an overview of the concept of these personality disorders, how these are related to schizophrenia, pharmacological and non-pharmacological interventions used for treating Cluster A personality disorders and relationship between these personality disorders and clinically high risk. We provide a narrative review of the evidence in these areas, and propose that early detection and treatment of these personality disorders may potentially help to prevent the transition to psychosis and complement the present research efforts for early intervention psychosis.

Online Publication Date Sep 27, 2022
Publication Date Sep 27, 2022
Deposit Date Mar 26, 2024
Publisher Springer
Pages 87-105
Book Title Psychosis and Personality Disorders
Chapter Number 5
ISBN 978-3-031-09057-8; 978-3-031-09060-8
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