Stress is definitely a factor - Stress makes everything worse
My 55 year old husband has just had his first attack of gout, in his finger. I immediately said, "It is due to the stress you are under this week". He has several work problems and is under enormous stress.
The reason I said that is because over the years, various members our family have had several conditions, ranging from severe chronic hives, tinnitus, asthma, eczema, infection, to food and chemical allergies. In every case, we have been able to relate the onset to stressful events, but this is not always apparent at the time. The family members have had to learn various ways of thinking & doing differently and have overcome their difficulties.
Naturally the genetic tendency towards the condition is there, along with other triggers, but through our experiences, I now believe stress is an overwhelming factor in most conditions, and gout is no different. Stress makes everything worse.