Internalized and Anticipated Stigmatization in Patients with Gout
Objective: To investigate the relationship between stigma perception and demographic, clinical, and psychosocial variables. Methods: A sample of 50 patients with gout and prescribed urate-lowering medication (84% were males, mean serum urate 0.34 mmol/l) completed questionnaires on internalized and anticipated stigma, demographics, clinical gout-related variables, and psychosocial variables (illness perceptions, illness-related disability, illness-related body satisfaction, intentional nonadherence). Serum urate level was obtained from the most recent blood test. Results: In this sample, 26% experienced internalized stigma, 26% expected to be stigmatized by friends or family members, and 14% by health care workers. Univariate regression analyses showed that younger age, ethnicity other than New Zealand European, increased severity of gout pain, cognitive and emotional illness perceptions, greater illness-related disability, and increased intentional nonadherence to urate-lowering medication were associated with increased internalized and anticipated stigma. Younger age, emotional illness response, and intentional nonadherence were the only variables explaining incremental variance of the experience of anticipated stigma in a multivariate regression model. Conclusion: Internalized and anticipated illness-related stigma was reported by a subgroup of patients with gout. The experience of stigma is associated with younger age, a negative emotional illness response, and intentions to not adhere with a medical treatment.