Mental responses in female patients with alopecia are not limited to anxiety and depressive symptoms and may involve a complex of interrelated states whose characteristics vary with the severity of mental maladaptation (MM).

Objective: to determine the features of anxiety, frustration, aggressiveness, and rigidity in female patients with alopecia at different levels of MM in order to identify markers of its progression and substantiate differentiated targets for care.

The study included 153 female patients with alopecia divided into three groups: without signs of MM (G1, n = 45), with isolated signs of MM (G2, n = 73), and with adjustment disorders (G3, n = 35). Mental states were assessed using the Self-Assessment of Anxiety, Frustration, Aggressiveness, and Rigidity questionnaire, an adapted version of H. Eysenck’s method.

The severity of all assessed states increased consistently with worsening MM. High anxiety increased from 4.4 % in G1 to 32.9 % in G2 and 71.4 % in G3; high frustration from 13.3 % to 28.8 % and 71.4 %; high rigidity from 6.7 % to 39.7 % and 54.3 %; and high aggressiveness from 17.7 % to 26.0 % and 57.2 %, respectively.

Increasing MM severity in alopecia is associated with a consistent restructuring of the mentalstate profile. Anxiety and frustration are the most prominent components of clinically manifest maladaptation, whereas a marked increase in rigidity is already evident at the intermediate level. Comprehensive assessment of these states may facilitate early identification of worsening MM and help define differentiated targets for psychiatric and medical-psychological care.