Comparing labels for persistent physical symptoms: A cross-sectional study among lay participants and healthcare...

Numerous labels are used to describe physical symptoms that remain for at least several months and cause significant distress (i.e., persistent physical symptoms, PPS). This study aims to assess attitudes associated with various labels among lay participants and healthcare professionals.

Participants recruited via mailing lists of volunteers completed an online questionnaire assessing their views on underlying physical and mental causations for ten diagnostic labels accounting for PPS. Lay participants rated their feelings of offence associated with each label, and healthcare professionals their willingness to take care of a patient diagnosed with each label. Mixed regression models investigated the factors associated with feelings of offence and willingness to care.

266 lay participants (mean age: 43; 70 % women) and 126 healthcare professionals (mean age: 42; 69 % women) were included. Labels rated high on perceived mental causation tended to be rated low on physical causation and vice versa in both populations, although this effect was stronger in lay participants. "Long COVID", "persistent physical symptoms" and "functional symptoms" were rated with higher physical causation by lay participants compared to health professionals (p < 0.001), whereas "somatic symptom disorder" and "psychosomatic" were rated with higher mental causation. Regression models showed that perceived mental causation was associated with feelings of offence in lay participants, while perceived physical causation was associated with less offence. Perceived physical causation was associated with willingness to care among healthcare professionals.

Some diagnostic labels provoke negative attitudes, both among lay participants and healthcare professionals, probably hindering clinician/patient relationships and treatment.