How this fits in

Primary care guidelines for managing persistent ‘medically unexplained’ physical symptoms recommend discussing the links between physical symptoms and negative emotions. When GPs propose these links, patients often find them unhelpful or actively block them. This study examined patients’ own descriptions of the links between physical symptoms and negative emotions, and found that patients articulated three types of associations: separated (negation that symptom and emotion were related); connected (symptom and emotion were presented as distinct but connected entities); and inseparable (symptom and emotion were combined within one entity). Understanding how patients describe associations between physical symptoms and negative emotions may help GPs to find common ground for communication and enable appropriate symptom management strategies to be constructed.