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Ask the Mental Health Expert Archives 2001-2004

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Schizotypal Personality Disorder

Q. I am a psychologist in Lubbock, Texas and am in private practice. I have been evaluating a 13 year old on referral from her psychologist. After a neuropsychological screening, academic and intellectual assessment, objective and projective testing, I am still stumped. The symptoms have similarities to Schizotypal Personality Disorder or adolescent onset Schizophrenia, but not purely so.

She has been followed by a Child and Adolescent Psychiatrist in our area and is on her third class of medications, all with either negative effects or adverse side effects without marked benefit. How do I locate a peer with whom I can share my data, and get the input of someone who is more familiar with schizophrenic spectrum disorders in children and adolescents than I am?

A. The differential diagnosis of schizotypal personality disorder (SPD) versus early schizophrenia can certainly be tricky--particularly since these may be temporal variants of the same underlying spectrum disorder, and/or share a bio-genetic basis, as I'm sure you know.

In this regard, you may be interested in the article, "Cognitive and brain function in schizotypal personality disorder" by LJ Siever et al, Schizophr Res 2002 Mar 1;54(1-2):157-67. Regarding peers who may be of help in looking over your raw data, I would suggest a few options: Diane E. Treadwell-Deering M.D, Chief of Psychiatry at Texas Children's Hospital in Houston, has subspeciality certification in neurodevelopmental disabilities. She would probably be in a good position either to help you or refer you to the proper individual [phone 832-822-3750].

At Children's Hospital of Minneapolis-St. Paul, both Bonnie Carlson-Green, Ph.D. and Jonathan Miller, Ph.D have expertise in neuropsychology, and might be in a position to help you analyze the data [phone: 612-813-6100].

You might also try contacting the American Academy of Child & Adolescent Psychiatry (202-966-7300) to see if they can recommend specialist consultants for this kind of problem. Good luck with this difficult case.

March 2003

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