Peculiarities of the affective sphere in patients with different forms of diffuse alopecia
Authors: Chemerys M.M. 
Published: September 2024

Background. To determine the peculiarities of the affective sphere in patients with different forms of diffuse alopecia, in order to develop personalized approaches to treatment and rehabilitation for this contingent of patients in the future. Purpose. To determine the features of the affective sphere in patients with different forms of diffuse alopecia, for the development, subsequently, personalized approaches to treatment and rehabilitation for this contingent of patients. Materials and Methods. Our examination involved 153 women aged 25 to 45 with diffuse alopecia. By means of a structured interview according to the criteria of International Classification of Diseases, 10th Revision (ICD-10) and the psychodiagnostic method, three groups were distinguished among female patients at the first stage of the work: without signs of mental maladjustment (MM) numbering 45 people (group 1 – G1); with separate signs of maladjustment, numbering 73 people (group 2 – G2); and with the adjustment disorders according to the ICD-10 criteria, numbering 35 people (group 3 – G3). Taking into account the genesis of alopecia within each of these groups the following two subgroups were distinguished: metabolic (45 patients) or mixed (108 patients). Further study of the affective sphere of the examinees, which was conducted at the second stage of the work, was carried out by clinical-psychopathological and psychometric methods (using Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) and The Beck Depression Inventory). Results. The mental state of patients with diffuse alopecia of both metabolic and mixed genesis is characterized by diversity and clinical-psychopathological heterogeneity along the axis «mental health – adjustment disorders F43.2». Among this contingent there are mentally healthy individuals (a total of 29.4%, 66.7% of them with metabolic alopecia, 13.9% with mixed alopecia), patients with mosaic signs of mental maladjustment (MM), the variability and intensity of which do not reach the nosologically defined level (only 47.7%, 20.0% of them with metabolic alopecia and 59.3% with mixed alopecia), and patients with adjustment disorders of cluster F43.2 (total 22.9%, 13.3% of them with metabolic form of alopecia and 26.8% with a mixed form of alopecia). Thus, the majority of female patients with diffuse alopecia are in a state of mental maladjustment (47.7%), having individual symptoms of different, but not very significant severity, while the quantitative difference of both mentally healthy people and persons with stress-associated adjustment disorders (29.4% and 22.9%, accordingly), is not statistically significant. In the structure of mental pathology in patients with diffuse alopecia, there are relevant differences depending on the genesis of the dermatological disease: mentally healthy people predominate (66.7%) among patients with metabolic alopecia, while among people with a mixed form of alopecia, the majority have signs of mental maladjustment (MM) (59.3%), and a little less than a third (26.8%) – clinically formed adjustment disorders. Clinical variability and intensity of psychopathological affective anxiety-depressive symptoms also varies depending on the genesis of alopecia, having significant differences in expressiveness in patients with a mixed form, in contrast to the metabolic one. This applies to both the leading depressive and anxiety clinical-psychopathological phenomena. Conclusion. The revealed regularities should be taken into account when developing a strategy of personalized treatment of patients with diffuse alopecia.