ACR2022 Gout update
Credit: Tatiana Ayazo

Key Takeaways 

  • Researchers find that many people with gout struggle with anxiety and/or depression, however treating gout properly can help lessen emotional distress. 
  • Artificial intelligence can be used to analyze data and spot trends related to people with chronic diseases. 
  • If you’re feeling anxious or depressed, talk to your rheumatologist or primary care provider, or connect with a mental health provider who specializes in working with patients with chronic illnesses.

Gout is well known for causing severe pain and redness in the big toe, but this form of inflammatory arthritis can sometimes cause pain and swelling in other joints, including the foot, knee, or ankle. You may also be surprised to learn that it can impact women as well as men (though it’s more prevalent in males) and that not everyone who has it is overweight (although obesity is a risk factor).  

Yet, perhaps the most surprising thing about gout, is that it’s also associated with mental health issues like depression and anxiety. 

“The association between gout and mental health issues is solid, especially in untreated patients,” says Daniel I. Hernandez, MD, Director of Medical Affairs and Hispanic Outreach for the Global Healthy Living Foundation.  

“There are a few possible reasons why mental health problems such as depression and anxiety often overlap with gout. One possibility is that the pain from gout can be very severe and lead to emotional distress,” he says, “Additionally, the burden of living with a chronic condition such as gout, if untreated, can be very stressful and lead to these.” 

With all this in mind, a group of researchers, including Hernandez, sought to learn more about the connection between gout and mental health in a real-world context.  

About the Study

The study, which was presented at the annual meeting of the American College of Rheumatology 2022 (ACR Convergence) in Philadelphia, used artificial intelligence (AI) to analyze anonymous data of discussions in online gout groups/threads on Facebook and Reddit. This enabled them to identify terms, concepts, topics, and trends related to gout and mental health. 

According to their findings, mental health was mentioned in about 4 percent of the posts and comments. Stress, depression, and anxiety were referenced most often. 

The study also revealed that patients were more apt to use negative words when discussing “urgent care” versus when they were talking about “primary care.” Seeking help via urgent care was often associated with the word “fear,” whereas primary care was more apt to be associated with “trust.”  

Hernandez believes that gout is less apt to be linked to mental health issues if it is well-controlled and patients don’t need to seek out quick help for flares. 

Our study agreed with other studies that have found that treating gout significantly decreases the likelihood of presenting with anxiety or depression,” says Hernandez, noting that this new research has two key takeaways. “The first is that the mismanagement of gout is not only physically damaging but holistically.”

The second: “AI and work like this creates exciting opportunities. A tool that could use this data to analyze disease-specific trends for other chronic diseases would be incredibly valuable for researchers and clinicians. It would allow them to better understand how patients are doing and what interventions are most likely successful. This information could help to improve the quality of life for patients with chronic diseases and reduce the overall burden of these illnesses.” 

What This Means for You

Figuring out how to improve mental health in people with gout is important for numerous reasons, and it’s worth noting that the association between gout and mental health might go both ways.  

Interestingly, earlier studies have uncovered some evidence that increased uric acid levels may be connected to anxiety and depression. (Gout occurs when uric acid levels get too high and form crystals that settle in joints.) This might explain why emotional stress has the potential to trigger a flare, though more research is needed.  

Either way, if you or a loved one has gout and is feeling anxious or depressed, it’s important to talk with your health care provider. Together, you can make sure that your gout is well-controlled and that you are taking the right steps to get the mental health help you need. 

Be Part of Arthritis Research

If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.

Flurie M, et al. Real-World Evidence from Social Media Provides Insights into Patient Mental Health Outcomes in the Management of Gout [abstract]. Arthritis & Rheumatology. 2022.  

Oliveira, L et al. “Uric Acid and Cortisol Levels in Plasma Correlate with Pre-Competition Anxiety in Novice Athletes of Combat Sports.” Brain Sciences. May 31, 2022. doi: 

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