Women with autoimmune diseases report waiting far longer than men for a diagnosis and more often hear that their symptoms are psychological, an international study of 6,607 patients shows. Researchers and guidelines set out what should happen when symptoms persist.
Being told that joint pain, exhaustion or a rash is down to stress can stop the search for an answer. For many women with autoimmune disease, that explanation came first and the correct diagnosis came years later.
Some 6,607 patients across several continents described their route to diagnosis. Dr Melanie Sloan of the University of Cambridge and the University of East Anglia led the study. Women were more likely than men to report that doctors first put their symptoms down to mental health. The study appeared in eClinicalMedicine, Cambridge announced on 12 October 2026.
Autoimmune diseases happen when the immune system attacks the body’s own tissues. They include rheumatoid arthritis, lupus and multiple sclerosis.
Psychiatric labels, by sex
Among women, 43% said their symptoms had been put down to a psychiatric cause, against 33% of men. Some 34% of women reported a psychosomatic misdiagnosis, meaning symptoms were blamed on stress or emotional distress. The figure for men was 22%.
The gap held after the researchers adjusted for age, disease group, continent and household finances. Women were almost 50% more likely than men to report a psychiatric misdiagnosis and nearly 75% more likely to report a psychosomatic one. Men were slightly more likely to be told they had a different physical disease, at 48% against 44% of women.
The most common time to diagnosis for men was under three months. For women it was one to two years. Some 60.4% of women waited more than a year, and nearly a third waited four years or longer, Euronews reported.
Shaista Tayabali, a co-author and patient partner, said labels such as hysteria are now rarely used. Even so, she said, “as women we still often have a harder time having our symptoms believed and therefore addressed accurately.”
A survey of patients’ own accounts
The study was a cross-sectional survey based on what patients reported, which can differ from medical records. It doesn’t establish why women and men were treated differently. The authors note that psychiatric diagnoses are sometimes correct, News-Medical reported. UK patient charities including Lupus UK and Sjögren’s UK funded the work, and patients helped design it. Sloan’s earlier 2020 survey of 233 people with lupus and related conditions found a mean wait of six years and 11 months.
Autoimmune disease is common, and most of those affected are women. A 2023 study of 22 million UK health records in The Lancet found 19 common autoimmune diseases affected 13% of women and 7% of men. In the US, women make up close to four-fifths of the roughly 8% of people living with an autoimmune disease, the National Institutes of Health says.
When symptoms keep coming back
Professor David D’Cruz, a consultant rheumatologist at Guy’s Hospital in London, was not an author. He said people can have both autoimmune and psychiatric conditions. “The important message is that when symptoms persist, evolve or involve multiple systems, clinicians must be open minded,” he said.
The research team calls on doctors to consider autoimmune diseases before giving a psychiatric or psychosomatic diagnosis. They also want clinicians to explain when patients should seek further assessment, and to revisit earlier decisions when new symptoms appear.
Existing guidance supports going back. The NHS in England advises people to see a GP if they often get symptoms of lupus, because it “is better managed if it’s found and treated early.” For suspected persistent joint inflammation, England’s National Institute for Health and Care Excellence recommends urgent specialist referral. That holds even with normal blood tests, if more than one joint or the small joints of the hands or feet are affected.
Sloan’s team now plans to work with patients and clinicians on ways to cut diagnostic delays and improve care. “Our next step is exploring the experiences and voices behind these numbers,” she said.
This article is for information only and does not replace advice from a qualified health professional.
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