schizotypal?

[Guest guest]

My dd is at UCLA and has been diagnosed as " schizotypal " .

She has had an eating disorder based on ocd beliefs/rituals (which

actually seems non existent now-outside of context of our home and

the eating rituals she had related to her sister, and to

scrupulosity).

The dx is based on social difficulty (can be withdrawn at times and

zoning out into her own dream world-possibly to extent that she mixes

up reality and not reality-but this hard to figure out), and odd

beliefs (magical thinking-but can't this be ocd?), and thinking

things like her identity could merge with someone else-which she

tries to resist but feels like it is involuntary (is this ocd in any

way?).

I have thought of her ocd as primary (since about age 8 when she

began having typical ocd behaviors) and the eating disorder secondary

to ocd, and the the social difficuty (social anxiety and

awkwardness, esp in groups, but desires one on one friendship which

she does have-but can be kind of dependent) as an aspergers type

profile (along with obsessive interests and severe sensory

integration type stuff). When I think of aspergers I think of

something that is not necessarily going to change alot with meds,

unless to reduce anxiety and associated ocd.

Anyway the medication they want to try is risperidone, an

antipsychotic. Since I have seen the most problematic or dysfunctionl

behaviors stemming from ocd- for example her eating disorder was all

ocd rituals to offset something (imagined as bad) from happening, I'm

wondering if an antipsyhotic will help, or is even necessary b/c the

eating rituals are not present any longer (and she claims she will

continue to eat more normally at home-but still has alot of weight to

gain-so needs to remain until she reaches a bit safer weight)

Btw I tend to trust her sincerity on this (about eating) b/c she

cannot lie very easily (which is something all the other anorexic

patients pretty much always try to do-it is just part of desperation

to avoid weight gain) and she does not ever try to deliberately

mislead people (which I have thought of as asperger-ish). But despite

her claims I still wonder if the rituals could come back

involuntarily when she comes home. (And will an antipsychotc prevent

this?)

Plus can an antipsychotic really change/help someone if they are

hghly introverted and can be withdrawn, and needing lots of down

time, and reduced stmulation (i.e reduced stress) or is this part of

a quirky anxious personality that needs some extra accomodations?

My question regarding this relates to going to highschool-will she be

able to start 10th grade highschool with the help of meds (this is

one of her treatment goals b/c they think all kids should be in

school so they can be as normal as possible) or should I accept that

she needs alot of acomodations/flexbility that is better provided

through homeschooling? I just don't think meds are suddenly going to

allow her to function in a big classroom/school.

Also can an antipsychotic (as opposed to SSRI) change " magical

thinking " if it is an ocd type thinking? Or does ocd overlap into

schizotypal when it is 'magical' thinking? (For example seeing random

things that are either good omens or bad omens, and beleiving

something bad will happen if she then does not do certain rituals).

So I'm wondering shouldn't she also try an SSRI, and be doing

exposures?

I asked these questions but they say the risperidone can help with

ocd rituals (no therapy?) AND anxiety AND ocd obsessions, AND odd

thinking/behavior- so it can kind of work across the board with co-

morbdities, I guess. That is ok with me if it works, I just want the

most destructve behaviors adressed which I see as the the compulsive

rituals and anxiety, moreso than the odd magical thinking/socially

awkward/ day dreaming personality.

So does any one else have experience with this diagnosis

(schizotypal) and use of antipychotic withOUT an ssri?

I am glad that they have recognized that it is not typical anorexia

and are trying to figure it all out more carefully.

nancy grace