Women with autoimmune diseases are more likely to be told their symptoms are psychosomatic, research suggests.
A study of sex differences in the diagnostic experiences of 6,607 people with autoimmune diseases also found that female patients were more likely to face delays in getting a correct diagnosis.
The findings published in The Lancet eClinicalMedicine, found that 43% of females reported that their autoimmune symptoms had previously been misattributed to a psychiatric cause, compared with 33% of males.
Being told that physical symptoms were caused or worsened by psychological factors was reported by 34% of females compared with 22% of males, the researchers from the University of Cambridge said.
The study was done internationally and open to adults with any autoimmune or rheumatic disease. Most respondents were female and almost 70% from the UK.
After taking into account age, disease group, continent and household finances, the researchers found that females were almost 50% more likely to report having received a psychiatric misdiagnosis and nearly 75% more likely to report a psychosomatic misdiagnosis than males.
Female respondents reported longer periods between the onset of symptoms and receiving their diagnosis, as well as more healthcare consultations, the researchers said.
For men, the most frequently reported time to diagnosis was less than three months, whereas for women, it was one to two years.
Dr Melanie Sloan, a senior researcher in the Department of Public Health and Primary Care at the University of Cambridge, and Norwich Medical School, University of East Anglia said: ‘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.
‘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.’
The high rates of reported psychiatric, psychosomatic and alternative physical misdiagnoses among both sexes reflects the difficulty of diagnosing autoimmune diseases, the researchers noted.
More research is needed to better understand why the reported differences occur, they added.
‘Our next step is exploring the experiences and voices behind these numbers and working with patients and clinicians to identify ways of reducing diagnostic delays and improving care,’ said Dr Sloan.
Professor David D’Cruz, consultant rheumatologist at Guy’s Hospital, said: ‘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.
‘They can also be a very natural response to living with life-changing illnesses.’
He added: ‘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.’
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