Personality Disorders in Patients with Idiopathic Generalized Epilepsy- An Underrecognized Comorbidity

Personality disorders remain an illness in the shadows, with scarce literature on their prevalence in persons with epilepsy. Moreover, personality traits in idiopathic generalized epilepsy (IGE) have not been explored so far, except for a few authors investigating juvenile myoclonic variant alone. We aimed to explore the prevalence and types of personality traits in persons with all IGE subtypes in adults and to compare them with the general population.

We included 57 healthy controls and 57 IGE cases who were diagnosed according to the International League Against Epilepsy criteria. The International Personality Disorder Examination-International Classification of Diseases 10 screening questionnaire was employed to investigate personality traits, while the Bear-Fedio inventory (BFI) was utilized to study several behavioral traits.

Compared with controls, a higher prevalence of personality traits was noted among patients with IGE (87.72% versus 36.84%, P = <0.001). They were more prevalent in females with IGE than in males (96.97% versus 75%; P = 0.034). Personality traits such as borderline ( P = <0.001), anankastic ( P = <0.001), anxious ( P = <0.001), histrionic ( P = <0.001), and impulsive ( P = 0.002) traits were higher in persons with IGE. Significantly higher scores in BFI were found among cases in all behavioral traits except hypermorality, altered sexual behavior, and dependence traits. On further analysis, no association of personality traits with the number of antiseizure medications or the duration of epilepsy was observed.

Deviant personality traits were significantly higher in patients with IGE. Regardless of the subtype of IGE, the existence of a personality disorder makes treatment more challenging. Hence, specific interventions addressing these disorders should be incorporated into patient management.