La schizotypie est un concept nosographique récent élaboré par Spitzer à la fin des années 1970, reposant sur l’analyse des caractéristiques des apparentés de sujets schizophrènes ayant participé aux études d’adoption réalisées par Kety, Wender et Rosenthal dans la même décade. Cependant, cette entité trouve ses bases dans des observations plus anciennes datant du début du siècle dernier et révélant certaines particularités comportementales et émotionnelles des apparentés de patients schizophrènes. Néanmoins, sa place au sein de nos nosographies actuelles reste incertaine, tantôt classée dans les troubles de la personnalité, tantôt dans la même catégorie que les troubles du spectre schizophrénique. Les avancées récentes concernant l’approche dimensionnelle des psychoses montrent une évolution du concept qui, d’un trouble étroitement lié à la schizophrénie, devient un trouble plus largement lié au concept de psychose unitaire et notamment, montrant des intrications avec le trouble bipolaire de l’humeur.

The schizotypal personality disorder is a recent psychiatric nosological concept developed by Spitzer at the end of the 1970s, based on the analysis of the characteristics of relatives of schizophrenic subjects included in the adoption studies carried out in the same decade by Kety, Wender and Rosenthal.

However, this entity is based on older observations, at the beginning of the past century, showing common behavioural characteristics in relatives of schizophrenics. Its status within our current nosography remains dubious, sometimes classified among personality disorders, sometimes in the schizophrenia spectrum disorders. It is interesting to present the origins of this concept that stem from two complementary approaches: a family approach and a clinical approach of sporadic cases and then to redefine the framework within which the diagnostic approach was based and its continuity, up until our current classifications, the DSM and CIM.

The historical origins cannot summarize the disorder and it appears important to redefine the multidimensional characteristics of the schizotypal personality disorder, generally a three-factor model. Indeed, dimensional models of psychosis are becoming established as conceptually and clinically useful. Recent studies on the dimensionality of psychosis show an evolution of the schizotypal concept, initially defined as being part of the schizophrenia spectrum and which now appears to be more broadly linked to a concept of unitary psychosis, including the bipolar disorder.

Dimensions of psychosis seem to be associated with different familial aggregation and risk of psychosis, suggesting that they are underlined by different physiopathological processes. Hence, the dimensional approach can help to disentangle the genetic heterogeneity of the disease.