Study Finds Women With Autoimmune Conditions More Likely to Be Told Symptoms Are Psychological
A University of Cambridge and University of East Anglia study reports women with autoimmune conditions are up to 74% more likely than men to be told their symptoms are psychosomatic and face longer waits for diagnosis.
The study included more than 6,600 people with autoimmune conditions. Most were female and from the UK. Patients listed their main condition, with almost a quarter of the women having autoimmune thyroid disease, which can cause the gland to become underactive, known as Hashimoto’s disease, or overactive, known as Graves’ disease. One in seven women in the study had systemic lupus. Among male patients, rheumatoid arthritis, vasculitis and antiphospholipid syndrome were the most common conditions.
Autoimmune conditions affect hundreds of millions of people, about one in 10 globally, and can cause a range of health issues including fatigue, muscle pain and rashes. They occur when the immune system attacks the body by mistake. They can be complex to diagnose because they often present with symptoms common in the wider population.
Researchers found 43% of women reported being told their condition was down to a psychiatric cause, compared with a third of men, or 33%. A third of women, or 34%, also reported having symptoms misdiagnosed as psychosomatic, meaning they were triggered or worsened by stress or anxiety, compared with 22% of men. After accounting for factors including age, disease group, continent and household finances, researchers said women were 46% more likely to report having received a psychiatric misdiagnosis and 74% more likely to report a psychosomatic misdiagnosis than men.
Women also reported much longer periods between the onset of symptoms and receiving a diagnosis, as well as more healthcare consultations. Among men, the most frequently reported time to diagnosis was less than three months. Among women, it was one to two years.
Melanie Sloan, the lead author and a researcher in the department of public health and primary care at Cambridge and UEA, said the damage caused to women by these types of misdiagnosis can be very long lasting in terms of trusting doctors and their own self-esteem. She said some women were forced to wait years before finally getting a diagnosis, causing long delays to treatment for their condition.
Sloan said the findings highlight that psychological or mental health explanations can be given too soon. She added that this is true for both sexes, but the study suggests females may be particularly vulnerable to these types of misdiagnoses. She said it is really important that symptoms are not automatically assumed to be psychological and for doctors to say, 'I believe you,' to patients with symptoms the doctors cannot see.
Shaista Tayabali, a patient affected by an autoimmune condition who was part of the research team and a co-author of the study, said the differences between the sexes in misdiagnoses for people with autoimmune diseases are stark. She said the fact that females reported higher rates of psychiatric and psychosomatic misdiagnoses than males suggests historical gender biases remain a challenging aspect of the diagnostic journey. Although labels such as hysteria are outdated and rarely used nowadays, she said, as women we still often have a harder time having our symptoms believed and therefore addressed accurately.
The study team said broader diagnostic challenges affect both sexes but females may face additional disadvantages. Historical biases in medicine may persist, including positioning females as less credible and emotional reporters of symptoms than males.