43% women with autoimmune diseases misdiagnosed with psychiatric conditions: Study
Autoimmune diseases occur when the body’s immune system mistakenly attacks the body’s own tissues. These include conditions like rheumatoid arthritis, lupus and multiple sclerosis.
Women with autoimmune diseases are more likely than men to have their conditions misdiagnosed as a psychiatric or psychosomatic condition. An international study published in The Lancet’s eClinical Medicine revealed that 43 per cent of women surveyed ...
In comparison, 33 per cent of men reported misdiagnosis of their autoimmune condition. The study analysing 6,607 reported diagnostic experiences of people with autoimmune diseases also found that women were also more likely to face delays in getting a correct diagnosis, and effectively the right treatment.
Autoimmune diseases occur when the body’s immune system mistakenly attacks the body’s own tissues. These include conditions like rheumatoid arthritis, lupus and multiple sclerosis. Autoimmune conditions are generally more common in women compared to men.
Why are autoimmune diseases hard to diagnose?
They are difficult to diagnose as the initial symptoms are fatigue, pain, sleep issues, or low mood, which are common for many health issues and are frequently seen due to poor lifestyle choices.
Dr Melanie Sloan from the Department of Public Health and Primary Care at the University of Cambridge, and Norwich Medical School, University of East Anglia explained that patients with autoimmune diseases can present with symptoms that can initially be difficult to explain medically,
and sometimes it can take months or years before a diagnosis becomes clear.
Gender bias in autoimmune diagnosis
“Our findings highlight that psychological or mental health explanations can be given too soon. This is true for both sexes, but our study suggests that females may be particularly vulnerable to these types of misdiagnosesm," Dr Sloan said.
Around 34 per cent women also reported that their conditions worsened by psychological factors. Shaista Tayabali, co-author of the study said: The differences between the sexes in misdiagnoses for people with autoimmune diseases is stark. The fact that females reported higher rates of psychiatric and psychosomatic misdiagnoses than males, yet reported lower misdiagnoses for other physical diseases, suggests that historical gender biases remain a challenging aspect of the diagnostic journey.
“Although labels such as hysteria are outdated, and fortunately rarely used nowadays, as women we still often have a harder time having our symptoms believed and therefore addressed accurately,” Tayabali added.
The study analysis also revealed that the researchers also found that females reported longer periods between the onset of symptoms and receiving their diagnosis, as well as more healthcare consultations.
Among males, the most frequently reported time to diagnosis was less than three months, whereas among females it was one to two years.
Clinicians should not dismiss patient symptoms
The researchers say patient perspectives are particularly important in diseases where symptoms may not be easily visible or where there is no definite diagnostic test.
Wendy Diment, patient partner in the study, said: "Most studies use medical records, but these are very one-sided as patient’s views are very rarely recorded and we often have different views on what is causing our symptoms to our doctors. They also do not always record when we first became unwell and the difficulties in getting our diagnosis, and they are very unlikely to be corrected when a psychosomatic ‘in your head’ type diagnosis is then found to be wrong."
Meanwhile, professor David D’Cruz, consultant rheumatologist at Guy’s Hospital, pointed out that it does not mean that a psychiatric diagnosis is never correct. People can have both autoimmune and psychiatric conditions, and it is increasingly understood that psychiatric symptoms can be part of an autoimmune disease, especially in diseases like lupus which can directly affect the brain.
The important message is that when symptoms persist, evolve or involve multiple systems, clinicians must be open minded and consider whether there is an underlying autoimmune disease that has not yet been recognised and listen to patients.