Women with autoimmune conditions more likely to be told symptoms are psychological, study finds

Women with autoimmune conditions are significantly more likely than men to have their symptoms attributed to psychological or psychosomatic causes, according to a new study. Among more than 6,600 patients, 43% of women said they were told their condition had a psychiatric cause, compared with 33% of men. A third of women (34%) reported symptoms misdiagnosed as psychosomatic, versus 22% of men. After adjusting for age, disease group, continent and household finances, the researchers found women were 46% more likely to report a psychiatric misdiagnosis and 74% more likely to report a psychosomatic one.

The study also found a gap in how long patients waited for answers. Men most frequently reported receiving a diagnosis in under three months, while women most often reported waiting one to two years. Women also reported more healthcare consultations. Lead author Melanie Sloan said the harm from such misdiagnoses can be long-lasting, affecting women's trust in doctors and their self-esteem.

The research, published in the Lancet eClinicalMedicine, was led by the University of Cambridge and University of East Anglia. Most participants were female and from the UK. Nearly a quarter of the women had autoimmune thyroid disease, which includes Hashimoto's disease and Graves' disease. One in seven women had systemic lupus. Among men, rheumatoid arthritis, vasculitis and antiphospholipid syndrome were the most common conditions.

Autoimmune conditions affect about one in 10 people globally and occur when the immune system mistakenly attacks the body. They can be difficult to diagnose because their symptoms—such as fatigue, muscle pain and rashes—are common in the general population. The study team said broader diagnostic challenges affect both sexes, but females may face additional disadvantages. They noted that historical biases in medicine may persist, including viewing women as less credible and more emotional when reporting symptoms.

Sloan said the findings show that psychological or mental health explanations can be offered too soon. She said this applies to both sexes, but women may be particularly vulnerable to such misdiagnoses. She stressed that symptoms should not automatically be assumed to be psychological and that doctors should tell patients they believe them when symptoms cannot be seen.

Shaista Tayabali, a patient with an autoimmune condition and a co-author of the study, said the differences between the sexes in misdiagnoses are stark. She said the higher rates of psychiatric and psychosomatic misdiagnoses reported by women suggest historical gender biases remain a challenging part of the diagnostic journey. Although terms like hysteria are outdated and rarely used now, she said women still often have a harder time getting their symptoms believed and properly addressed.