London: Women with autoimmune conditions are significantly more likely than men to have their symptoms wrongly attributed to psychological or psychosomatic causes and often face longer delays in receiving a diagnosis, according to a study by the University of Cambridge and the University of East Anglia.
The research, published in The Lancet eClinicalMedicine, analysed responses from more than 6,600 people with autoimmune conditions, most of whom were women living in the UK. The findings highlight differences between men and women in their experiences of diagnosis and healthcare.
Autoimmune conditions occur when the immune system mistakenly attacks the body’s own tissues. They can cause a wide range of symptoms, including persistent fatigue, muscle pain, and skin rashes, making diagnosis challenging because these symptoms can overlap with those of other conditions.
Psychiatric or psychosomatic?
- The study found that 43 percent of women reported being told their symptoms had a psychiatric cause, compared with 33 percent of men.
- Meanwhile, 34 percent of women noted that their symptoms had been misdiagnosed as psychosomatic, compared with 22 percent of men.
- Psychosomatic symptoms are physical symptoms that may be triggered or worsened by psychological factors such as stress or anxiety.
After accounting for factors including age, disease group, continent and household finances, researchers found that women were 46 percent more likely than men to report a psychiatric misdiagnosis and 74 percent more likely to report a psychosomatic misdiagnosis.
Women also reported longer waits between symptom onset and diagnosis, as well as more consultations with healthcare professionals. The most commonly reported time to diagnosis among men was less than three months, while women most frequently reported waiting between one and two years.
Differences in autoimmune conditions
The participants reported a range of autoimmune diseases. Nearly a quarter of the women in the study had autoimmune thyroid disease, including Hashimoto’s disease, which can cause an underactive thyroid, and Graves’ disease, which can lead to an overactive thyroid.
Hashimoto’s disease may cause fatigue, weight gain, hair loss and joint pain, while Graves’ disease can cause symptoms such as palpitations, weight loss and bulging eyes.
Systemic lupus, which can cause fatigue, muscle pain and rashes, affected approximately one in seven women in the study. Among male participants, rheumatoid arthritis, vasculitis and antiphospholipid syndrome, sometimes called sticky blood syndrome, were among the most commonly reported conditions.
Gender differences in diagnosis
The researchers acknowledged that diagnosing autoimmune diseases can be difficult for both sexes because symptoms are often varied and may resemble those associated with more common health conditions. However, the findings suggest that women may face additional barriers during the diagnostic process.
The study highlighted the possibility that historical gender biases in medicine could influence how symptoms are interpreted, including perceptions that women are more emotional or less credible when describing their health concerns.
Lead researcher Melanie Sloan, from the departments of public health and primary care at the University of Cambridge and the University of East Anglia, said psychological explanations may sometimes be considered too early when patients present with symptoms that are difficult to identify or measure.
The researchers emphasised the importance of taking patients’ symptoms seriously and avoiding assumptions that unexplained physical symptoms are necessarily psychological.
The findings point to the need for greater awareness of potential gender differences in healthcare experiences and for further attention to diagnostic delays and the interpretation of symptoms in people with autoimmune conditions.
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