Deficient visual sensitivity in schizotypal personality disorder

Schizotypal personality disorder is a personality disorder in the schizophrenia spectrum, sharing genetic and neurobiologic characteristics with schizophrenia. Visual contrast detection, found to be abnormal in chronic schizophrenia, was investigated in schizotypal personality disorder (SPD). Since dopamine in the retina enhances visual contrast detection and SPD patients have relatively reduced dopaminergic activity in the brain compared to schizophrenia patients, it was hypothesized that SPD patients would have decreased to normal contrast sensitivity. Twenty-one subjects with DSM-IV diagnosed SPD, 18 healthy controls, and 12 subjects with a personality disorder unrelated to schizophrenia (OPD) were evaluated for contrast detection using a sinusoidal grating presented at varying temporal frequencies. Subjects also were evaluated neuropsychologically using several standardized neurocognitive tests. A significant effect of subject group was found on the contrast detection threshold (p < 0.01) with a significant difference between the SPD group and the healthy control group but not between the OPD group and the healthy control group. The SPD group had higher contrast detection thresholds at all temporal frequencies tested. Correlations were found between contrast detection and performance on the Trail-Making, N-Back, and CPT tasks in SPD patients. These results, based upon a paradigm reflecting dopamine activity in the early visual system, highlight the differences as well as similarities between SPD and schizophrenia with regard to the dopamine system in schizophrenia spectrum (Siever and Davis, 2004).