Which diagnosis best fits duration, episodicity, and exclusions?
A
Schizotypal personality disorder
Pervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
AA. Pervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
BA. Persistent deficits in social communication/interaction across multiple contexts (≥3 components: social-emotional reciprocity; nonverbal communicative behaviours; developing/maintaining relationships) B. Restricted, repetitive patterns of behaviour/interests/activities (≥2 of: stereotyped/repetitive motor movements; insistence on sameness/inflexible routines; highly restricted interests; hyper/hyporeactivity to sensory input) C. Symptoms present in early developmental period (may not fully manifest until social demands exceed capacity)
Common specifiers
ASeverity (Mild / Moderate / Severe)
BWith/without accompanying intellectual impairment; With/without accompanying language impairment; Associated with a known medical or genetic condition; Associated with another neurodevelopmental, mental, or behavioural disorder
Differential flags
ASchizophrenia (active psychosis; duration criteria; role decline); Delusional disorder (fixed false beliefs at full intensity); Schizoid PD (isolation without odd beliefs)
BADHD (comorbid in ~50%; social deficits not as pervasive; no RRBs - code both when criteria independently met); Social anxiety disorder (fear of negative evaluation; social motivation and desire intact); Social (pragmatic) communication disorder (social deficits without RRBs - mutually exclusive with ASD)