Females with autoimmune disease report more psychiatric misdiagnosis
The researchers want doctors to consider autoimmune disease before giving a psychiatric or psychosomatic diagnosis.
Females with autoimmune diseases are significantly more likely than males to report a psychiatric or psychosomatic misdiagnosis, the University of Cambridge has said.
A study in The Lancet’s eClinicalMedicine analysed the reported diagnostic experiences of 6,607 people with autoimmune diseases, the university said in a news release dated 12 October 2026. It was led by Cambridge and the University of East Anglia (UEA).
In the study, 43% of females reported that their autoimmune symptoms had previously been misattributed to a psychiatric cause, compared with 33% of males.
A psychosomatic misdiagnosis, meaning that physical symptoms were caused or worsened by psychological factors, was reported by 34% of females and 22% of males.
After accounting for age, disease group, continent and household finances, females were almost 50% more likely to report a psychiatric misdiagnosis and nearly 75% more likely to report a psychosomatic one.
Males were slightly more likely to report being misdiagnosed with a different physical disease, at 48% against 44% for females.
Females also reported more healthcare consultations on the way to a diagnosis. The most frequently reported time from symptoms to diagnosis was one to two years among females, against less than three months among males.
Why the diagnosis is hard
Autoimmune diseases occur when the immune system mistakenly attacks the body’s own tissues, and they include rheumatoid arthritis, lupus and multiple sclerosis. Many begin with fatigue, pain, sleep disturbance or low mood, which are common in the general population, and symptoms can change over time.
The team is calling for doctors to consider autoimmune diseases before any psychiatric or psychosomatic diagnosis is given.
“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,” said Dr Melanie Sloan, of the Department of Public Health and Primary Care at the University of Cambridge and Norwich Medical School, University of East Anglia.
Professor David D’Cruz, a 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, D’Cruz said, 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.
Shaista Tayabali, a co-author and patient partner, said: “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.”
Unlike studies based solely on medical records, the research focused on patients’ own accounts of their diagnostic journeys, the university said.
Sloan said it is first necessary “to understand why these differences occur” before effective solutions can be designed. The team’s next step is working with patients and clinicians to identify ways of reducing diagnostic delays and improving care.
