Misdiagnosis of Rheumatic Autoimmune Diseases Leads to Depression and Distrust in Healthcare Providers

The analysis involved two cohorts of SARD patients (over 3,500 individuals) from other projects (LISTEN and INSPIRE). Patients who had been misdiagnosed with psychiatric or psychological conditions were compared with those who had not had this experience.

Their levels of depression, anxiety, and psychological well-being were assessed using validated scales (e.g., WEMWBS, PROMIS, GAD-7). Data were also collected on patients’ trust in physicians and satisfaction with their treatment.

Emotional Scars Remain

In 80% of affected patients, misdiagnosis had a negative impact on their self-esteem. Among 72% of participants, experiencing a misdiagnosis of a mental health disorder was linked to poorer psychological outcomes—significantly lower mental well-being, higher levels of depression and anxiety, and lower satisfaction with all aspects of medical care compared to those without such experiences.

In some patients, misdiagnosis triggered feelings of shame, self-doubt, and depression; in others, it escalated to suicidal thoughts or even suicide attempts.

Among those affected by misdiagnosis, some began concealing symptoms or avoiding healthcare services. However, adherence to treatment was not affected. This avoidance behavior stemmed from distrust or fear that clinicians would not believe their symptoms or would assign them a different diagnosis.

How Physicians Can Make a Difference

Autoimmune diseases are notoriously difficult to diagnose quickly. Nonetheless, some physicians may prematurely conclude that symptoms are due to psychiatric or psychosomatic conditions. A long list of symptoms should raise suspicion of an autoimmune condition—not skepticism toward the patient's complaints.

Moreover, many symptoms are subjective, making it hard for clinicians to fully grasp the patient’s suffering. Clinically detached language in medical records—such as phrases like “as reported by the patient” combined with “no objective signs of disease”—can further exacerbate the issue.

Healthcare providers should approach patients at high risk of misdiagnosis with greater sensitivity and offer support in coping with the lasting effects of diagnostic errors.

Editorial Team, Medscope.pro

Sources:

1. Sloan M. ‘I still can’t forget those words’: mixed methods study of the persisting impact on patients reporting psychosomatic and psychiatric misdiagnoses. Rheumatology 2025, doi: 10.1093/rheumatology/keaf115.

2. Sloan M. All in your head: when doctors misdiagnose autoimmune disease as psychosomatic. Theconversation.com, March 3, 2025. Available at: www.theconversation.com/all-in-your-head-when-doctors-misdiagnose-autoimmune-disease-as-psychosomatic-250953

3. Autoimmune diseases misdiagnosed as psychosomatic can lead to long-term damage to physical and mental well-being. Medicalexpress.com, March 2, 2025. Available at: www.medicalxpress.com/news/2025-02-autoimmune-diseases-misdiagnosed-psychosomatic-term.html

4. Gainty C. Medical gaslighting: when conditions turn out not to be ‘all in the mind’. Theconversation.com. Available at: www.theconversation.com/medical-gaslighting-when-conditions-turn-out-not-to-be-all-in-the-mind-209611