Women ‘more likely to be told autoimmune conditions are psychological’

A Cambridge University study reveals a stark gender divide in how doctors diagnose autoimmune conditions, with women far more likely than men to be told their symptoms are psychological rather than physical.

The research, published in the Lancet eClinicalMedicine journal, analysed responses from over 6,600 people with autoimmune conditions, mostly women in the UK. Forty-three per cent of women reported being told their condition stemmed from psychiatric causes, compared with 33 per cent of men. A third of women (34 per cent) had symptoms misdiagnosed as psychosomatic, triggered or worsened by stress or anxiety, versus 22 per cent of men.

After accounting for age, disease group, continent and household finances, researchers found women were 46 per cent more likely to receive a psychiatric misdiagnosis and 74 per cent more likely to receive a psychosomatic misdiagnosis than men.

Women also faced substantially longer diagnostic delays. Among men, the most common time to diagnosis was less than three months. For women, it was one to two years. Women also reported more healthcare consultations before diagnosis.

Melanie Sloan, lead author and researcher at Cambridge and the University of East Anglia, said the damage from such misdiagnosis could be long-lasting. "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 had waited years for a correct diagnosis, delaying proper treatment.

Common autoimmune conditions in the study included autoimmune thyroid disease in nearly a quarter of women, causing fatigue, weight changes and hair loss. One in seven women had systemic lupus, triggering tiredness and rashes.

The research team noted that "broader diagnostic challenges affect both sexes" but "females may face additional disadvantages". They attributed this partly to "historical biases in medicine," including perceptions that women are "less credible and emotional reporters of symptoms than males."

Sloan said doctors must avoid assuming symptoms are psychological automatically. "It is really important that symptoms are not automatically assumed to be psychological and for doctors to just say, 'I believe you,' to patients with symptoms that the doctors cannot see," she said.

Shaista Tayabali, a patient co-author on the study, noted that historical gender biases persist. "Although labels such as hysteria are outdated... as women we still often have a harder time having our symptoms believed and therefore addressed accurately," she said.