Women with autoimmune diseases more often get psychological misdiagnoses, study finds
A study led by researchers at Cambridge and the University of East Anglia found that 43% of women with autoimmune conditions were told their illness had a psychiatric cause, against 33% of men. Women also reported waiting one to two years for a diagnosis, while most men said it took under three months.
What the study found
The study, published in the journal Lancet eClinicalMedicine, surveyed more than 6,600 people living with autoimmune conditions, most of them women in the United Kingdom. Researchers from the University of Cambridge and the University of East Anglia (UEA) asked participants to name their main condition and describe how it was diagnosed. Among women, 43% said they had been told their condition had a psychiatric cause, compared with 33% of men. Another 34% of women said their symptoms had been misdiagnosed as psychosomatic, against 22% of men. After accounting for age, condition type, continent and household finances, women were 46% more likely than men to report a psychiatric misdiagnosis and 74% more likely to report a psychosomatic one.
- Women: psychiatric cause
- 43 %
- Men: psychiatric cause
- 33 %
- Women: psychosomatic misdiagnosis
- 34 %
- Men: psychosomatic misdiagnosis
- 22 %
Longer waits for a correct diagnosis
Women also reported longer gaps between first symptoms and diagnosis, along with more visits to doctors. Most men said the time to diagnosis was less than three months, while the most common answer among women was one to two years. Melanie Sloan, the lead author, said the damage caused by such misdiagnoses can last a long time, affecting women's trust in doctors and their self-esteem. She noted that it can sometimes "take months or years before a diagnosis becomes clear". The study found that some women are forced to wait years before they learn which condition they have, which delays the start of treatment.
Symptoms that are easy to dismiss
Autoimmune conditions occur when the immune system mistakenly attacks healthy tissue. They often begin with common symptoms such as fatigue, muscle pain and rashes, which makes them hard to identify for both sexes. Hashimoto's disease can cause weight gain, hair loss, fatigue and joint pain, while Graves' disease can cause bulging eyes, palpitations and weight loss. Systemic lupus can cause tiredness, rashes and muscle pain, and roughly one in seven women in the study had it.
Who took part
According to the participants' own reports, almost a quarter of the women had autoimmune thyroid disease, such as Hashimoto's or Graves' disease. Among men, the most common conditions were rheumatoid arthritis, vasculitis and antiphospholipid syndrome. Men were slightly more likely to report being misdiagnosed with a different physical disease, 48% against 44% for women. The sample was drawn mainly from the United Kingdom, which limits how far the figures can be applied elsewhere.
Limits and the researchers' explanation
The authors describe their results as exploratory. Because the data come from questionnaires, delays and misdiagnoses may be perceived by patients and not confirmed in medical records. The researchers said the broader diagnostic challenges affect both sexes, but that "females may face additional disadvantages". They pointed to "historical biases in medicine" that may persist, including the view that women are less credible and more emotional when describing their symptoms than men.
