Scientists have pointed to the frequency of misdiagnoses in women with autoimmune diseases
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- Scientists have pointed to the frequency of misdiagnoses in women with autoimmune diseases
Women with autoimmune diseases are more likely than men to be confronted with the fact that physical symptoms are attributed to mental causes. In addition, they often have to wait longer for a correct diagnosis. About why it can be more difficult for women to achieve an accurate diagnosis of autoimmune diseases — in the Izvestia article.
Female symptoms are more often attributed to mental causes.
According to a study published in the journal EClinicalMedicine, 43% of women with autoimmune diseases reported that their symptoms had previously been mistakenly attributed to mental causes. Among men, 33% reported such an experience. A psychosomatic explanation, in which physical symptoms are considered to be caused or enhanced by psychological factors, was given by 34% of women and 22% of men.
Scientists from the University of Cambridge and the University of East Anglia analyzed the diagnostic experience of 6,607 people with autoimmune diseases. After taking into account age, group of diseases, continent of residence and financial situation, the researchers found that women were almost 50% more likely than men to report an erroneous psychiatric diagnosis and almost 75% more likely to report a psychosomatic one.
Shaista Tayabali, co-author of the study
The differences between men and women in the rate of misdiagnosis in people with autoimmune diseases are striking. The fact that women were more likely to report psychiatric and psychosomatic misdiagnoses, but less likely to misdiagnose other physical illnesses, indicates that historically established gender biases continue to complicate the path to diagnosis.
She added that although labels such as "hysteria" are outdated and rarely used today, it is still more difficult for women to ensure that their symptoms are taken seriously and properly assessed.
You have to wait years for a correct diagnosis.
The researchers also found differences in the timing of diagnosis. Among men, the most common period from the onset of symptoms to diagnosis was less than three months. Women were more likely to report that the wait took between one and two years. In addition, they indicated a higher number of requests for medical help.
Melanie Sloan, Specialist in the Department of Public Health and Primary Care at the University of Cambridge and the Norwich Medical School at the University of East Anglia
Patients with autoimmune diseases may experience symptoms that are difficult to explain medically at first, and sometimes months or years pass before the diagnosis becomes clear.
According to her, the results of the study show that explanations related to psychological reasons or mental health sometimes appear too early. This applies to both sexes, but women, according to the findings, may be particularly vulnerable to such misdiagnoses.
Why autoimmune diseases are difficult to recognize
Autoimmune diseases occur when the immune system mistakenly attacks the body's own tissues. These include rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis. Many autoimmune diseases are more common in women.
Diagnosis can be difficult because in the early stages such diseases cause non—specific symptoms such as fatigue, pain, sleep disorders or decreased mood. These manifestations are also common among people without autoimmune diseases. Symptoms can also affect different parts of the body and change over time. It is especially difficult to recognize diseases that have few noticeable external signs or no clear changes in the results of blood tests.
However, errors are not limited to psychiatric diagnoses. 48% of men and 44% of women reported that they had been misdiagnosed with another physical illness. Thus, difficulties in recognizing autoimmune diseases affect both sexes, although the nature of misdiagnoses varies.
Psychological explanations can delay diagnosis.
The high frequency of misdiagnoses of various types in men and women reflects the difficulty of recognizing autoimmune diseases. The authors of the study urge doctors to consider this possibility before definitively explaining the symptoms for mental or psychosomatic reasons.
The importance of taking into account the patient's experience was emphasized by one of the study participants, Wendy Diment. She noted that medical records do not always reflect how people perceive their symptoms themselves, when they first felt unwell and what difficulties they faced before diagnosis.
Wendy Diment
Most studies use medical records, but they reflect the situation from only one angle: patients' opinions are rarely recorded, and our understanding of the causes of symptoms often differs from that of doctors. The documents also do not always indicate when we first felt unwell and what difficulties we faced when making the diagnosis.
The study was developed with the participation of patients, charities and doctors. Unlike studies based solely on medical documents, it relied on people's stories about their own diagnostic path: participants reported how long it took from the onset of symptoms to diagnosis, how many times they sought help, and what diagnoses they had received earlier.
Mental disorder does not exclude autoimmune disease
The authors of the study emphasize that the presence of a mental disorder does not exclude an autoimmune disease. These conditions can occur simultaneously. Moreover, some autoimmune diseases can directly affect the brain and be accompanied by mental symptoms.
Such manifestations, for example, can be observed in systemic lupus erythematosus. Psychological difficulties can also be a natural reaction to living with a disease that significantly changes a person's daily routine.
David D'Cruz, Consulting Rheumatologist at Guy's Hospital in London
It's not that a psychiatric diagnosis is never correct. A person may have an autoimmune disease and a mental disorder at the same time. In addition, more and more evidence indicates that mental symptoms may be part of an autoimmune disease, especially one such as lupus, which can directly affect the brain. They can also be a natural reaction to living with a life-changing disease.
According to him, if symptoms persist, change, or affect multiple body systems, doctors should consider the possibility of an autoimmune disease that has not yet been identified and listen carefully to patients.
The researchers also suggest recognizing the uncertainty of the diagnosis, explaining to patients in which cases additional examination is necessary, and returning to previous diagnostic solutions if new symptoms or information appear. Melanie Sloan noted that before developing effective ways to reduce delays, it is necessary to understand the reasons for the differences between men and women. In the next step, the scientists plan to study the experience of patients and doctors in more detail in order to find ways to improve diagnosis and medical care.
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