The relationship between epilepsy and personality disorders is not often the subject of many scientific investigations. Much research concentrates on psychiatric disorders, such as psychotic disorders, anxiety disorders, and mood disorders, whereas personality disorders are less likely studied in epilepsy.
This study was conducted upon 90 epileptic patients presented at outpatient clinic of epilepsy in Assiut University Hospital along with 40 healthy adult subjects volunteered to participate in the study.
In this study, epilepsy was more common in females (48 (53.33%)) than in males (42 (46.67%)); similar data were obtained from Tang et al. (2012) , and in his study of anxiety, prevalence in epileptic patients as they found that 52.6% of them were females and 47.4% were males.
Regarding the five-factor model of personality, in the current study, we found that neuroticism was highest at patients with refractory epilepsy with a mean of 25.51 and SD ± 7.72 than the mean of the controlled epileptic patients 22.02 and SD ± 8.92, while lowest at control people 17.93 and SD ± 7.99, with a highly significant statistical difference.
For extraversion, it was lowest at the refractory epileptic patients with a mean of 25.51 and SD ± 7.72; while in controlled epileptic patients, the mean was 20.02 and SD ± 8.77, and highest in the control group with a mean of 22.28 and SD ± 9.98 without significant statistical difference.
For openness to experience, it was lowest at refractory epileptic patients with a mean of 7 and SD ± 4.54, and higher in control people with a mean of 10.1 and SD ± 8.81, while highest in controlled epileptic patients with a mean of 11.07 and SD ± 9.74 with a significant statistical difference.
For agreeableness, it was lowest at refractory epileptic patients with a mean of 25.64 and SD ± 5.25, higher in control group 25.68 and SD ± 7.65 and highest in controlled epileptic patients 27.78 and SD ± 6.48, without significant statistical differences. For conscientiousness, it was lowest at refractory epileptic patients with a mean of 12.8 and SD ± 6.02, higher in control people 13.85 and SD ± 5.03, and highest in controlled epileptic patients 16.8 and SD ± 6.79, with a highly significant statistical difference.
This was in agreement with Swinkels et al. (2004)  who stated in his study that the patients with epilepsy exhibit more personality disorder traits compared with a control group from the general population. Also, he agreed with us that he found a relationship that exists between personality disorders traits and the severity of epilepsy. When patients have more severe epilepsy, they often have a high seizure frequency, and they use more antiepileptic medications.
Also, Swinkels et al. (2003) have a similar data showing that, compared with the control group, patients with epilepsy had higher dimensional scores for several Diagnostic and Statistical Manual of Mental Disorders of personality disorders. Associations were found between PD traits and age at onset of epilepsy, duration of epilepsy and seizure frequency .
It is likely that in those patients, the need for control is usually high (because seizures mean a loss of control). Therefore, they are probably more prone to develop a behavior pattern that corresponds with cluster C personality disorders traits. Also, our results agreed with Faustino Lopez et al. (1999)  who stated that the severity of epilepsy is associated with decreased psychosocial well-being and increased psychopathology as epilepsy is a disabling disorder that have a higher feeling of decreased control and perception of being stigmatized and finally low self-esteem . And this was also agreed with Swinkels (2004)  who concluded from his study that patients with epilepsy have raised scores for a number of personality disorder traits. Those who are suffering from repeated epileptic seizures have disturbances in the development of personality characteristics, which could explain the relationship between the development of personality disorder traits with the severity and duration of the epilepsy.
Also agreed with Wang X, et al. (2018)  who used Eysenck Personality Questionnaire on epileptic patients and showed that patients with epilepsy were presented with significant cognitive impairment and particular personality traits, and epileptic seizure-related factors including earlier age of onset, longer duration of epileptic history, and high seizure frequency were significantly associated with the observed defects in cognition and personality traits.
Bazarnik A. (2018)  also agreed with us and concluded that many patients with epilepsy report numerous complaints about worsening of their emotional, cognitive, and social functioning so he emphasized that when evaluating diverse psychological variables such as personality traits. It is possible to draw some conclusions about the inclination of patients with epilepsy to develop specific mental disorders.
Regarding intelligence quotient (IQ), this study showed significant statistical difference in the performance of the controlled epileptic patients with mean of 92.38 and SD ± 4.12 over the refractory epileptic patients with mean of 90.16 and SD ± 4.4 and the control group with mean of 91.6 and SD ± 4.3. This means that the performance of the controlled epileptic group (with the better seizure control) is almost close to the control group, meaning that the severity of epilepsy affects the IQ performance scale of the cases.
Refractory epileptic verbal means 80.67 with SD ± 4.94, but without significant statistical difference. Lastly, the deterioration index was higher in controlled epileptic patients with a mean of 8.33 with SD ± 9.55; while in refractory epileptic group, it was 8.29 with SD ± 7.09, and in control group was 8.16 with SD ± 8.78 with no significant differences.
This was agreed with Wang X, et al. (2018)  who used the Wechsler Adult Intelligence Scale-Chinese revised and found that patients with epilepsy were presented with significant cognitive impairment. Also, Jacoby et al. (1994)  reported that 18% of epileptics were classified as mentally handicapped .