New Delhi: A study of 6,600 patients with autoimmune diseases found that women are far more likely than men to have their illness misdiagnosed as a psychiatric or psychosomatic condition.
The international study published on 12 October in The Lancet’s eClinicalMedicine, was led by researchers at the University of Cambridge and University of East Anglia. They also found that women were more likely to face delays in receiving a correct diagnosis and the right treatment for their illness.
“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 Although labels such as hysteria are outdated, and fortunately rarely used nowadays, as women we still often have a harder time having our symptoms believed and therefore addressed accurately,” co-author Shaista Tayabali said in a statement.
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A difficult diagnosis
Autoimmune diseases occur when the immune system attacks the body’s own tissues by mistake. These conditions include rheumatoid arthritis, lupus, multiple sclerosis, and several others. Diagnosing such diseases is not easy because the symptoms are often just fatigue, pain, sleep disturbance, or a low mood.
According to the study, 43 per cent of females report that their autoimmune symptoms were misattributed to a psychiatric cause. Many of them were also told that psychological factors simply worsened their physical symptoms.
“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 misdiagnoses,” Melanie Sloan from the Department of Public Health and Primary Care at the University of Cambridge said in a statement.
To make sure the study did not rely only on medical records, researchers designed the process with patients, charities, and clinicians to find out what might often get missed. Participants were asked about their symptoms, their diagnosis, the number of consultations they had, and all the different types of diagnosis they had received before they were told they had an autoimmune disease.
“This is not about saying 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 to listen to patients,” said professor David D’Cruz, Consultant Rheumatologist at Guy’s Hospital.