Disclosures: Dalbeth reports consulting or speaking fees from AstraZeneca, Horizon, Selecta, Arthrosi, Dyve BioSciences, Hengrui, AbbVie and Janssen.
February 09, 2021
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Film, television may reinforce stereotypes, misconceptions about gout

Disclosures: Dalbeth reports consulting or speaking fees from AstraZeneca, Horizon, Selecta, Arthrosi, Dyve BioSciences, Hengrui, AbbVie and Janssen.
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Contemporary films and television shows portray gout as a funny or embarrassing condition triggered by dietary indulgence, potentially reinforcing inaccurate beliefs about the disease, according to findings published in BMC Rheumatology.

“People with gout may experience stigma and embarrassment, as gout is often perceived as caused by excessive food and alcohol intake,” Nicola Dalbeth, MBChB, MD, FRACP, of the University of Auckland in New Zealand, told Healio Rheumatology. “Biological causes of gout such as genetic risk factors or kidney disease are not as well recognized in the community. This study shows that gout is often depicted in contemporary film and television as being caused by overindulgence of food and alcohol, and as a humorous condition. These depictions may reinforce negative cultural stereotypes about gout.”

“The perception of gout as an embarrassing and humorous condition can make it more difficult for people with gout to seek medical treatment,” Nicola Dalbeth, MBChB, MD, FRACP, told Healio Rheumatology. “Understanding how community perceptions about gout develop can help us to address stereotypes and misconceptions about gout.” Source: Adobe Stock

To examine fictional depictions of gout in contemporary film and television, Derksen and colleagues searched the Internet Movie Database (IMDb) as well as other media databases and suggestions from the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN). Other databases included in the analysis were the Literature, Arts and Medicine Data Base, Allmovie.com, Reel.com, Rottentomatoes.com, ForeignFilms and the Bollywood Movie Database.

Focusing on English-language movies and television shows released since 1990, the researchers used the keyword “gout” to review titles, plot descriptions, quotes and trivia. In addition, “gout film,” “gout movie,” “movie showing/ depicting gout,” “film showing/ depicting gout,” “film character with gout,” “movie character with gout,” “TV show gout” and “TV show character with gout” were used in Google searches. Documentaries and reality shows were excluded. Identified movies and television episodes were watched in full, as the researchers analyzed each for depictions of gout, causal factors and management strategies.

Nicola Dalbeth

In all, the researchers identified 153 results from IMDb, with an additional 23 from G-CAN member input. No results were obtained from the other database searches. Among the collected results, 129 were excluded, leaving a total of 44 entries — 29 television episodes and 15 movies — for analysis.

According to the researchers, movies and television used gout to denote royalty or nobility in historical settings, and as a plot device to explain the absence of characters during important events. The most common cause of gout in these portrayals — seen in 61% of the included entries — was overindulgence of food and alcohol. In contrast, just 12% depicted the biological causes of the disease.

Common management strategies in these movies and shows were change in diet — seen in 36% of the included entries — and short-term pain relief — as seen in 32%. Only one entry mentioned the use of urate-lowering therapy.

In all, 59% of included films and television episodes portrayed gout as humorous, while 50% played it as embarrassing.

“Most films and television episodes depicted gout as a humorous and embarrassing condition, caused by overindulgence of food and alcohol, and treated by dietary change,” Dalbeth said. “Depictions of appropriate medical management, with urate lowering medications such as allopurinol, were very infrequent. These depictions may reinforce inaccurate beliefs about how gout should be managed.”

“The perception of gout as an embarrassing and humorous condition can make it more difficult for people with gout to seek medical treatment,” she added. “Understanding how community perceptions about gout develop can help us to address stereotypes and misconceptions about gout.”