Clinical factors associated with anxiety symptoms in patients with ulcerative colitis

doi:10.3969/j.issn.1004-583X.2026.07.004

Abstract

Abstract:

Objective To analyze the clinical factors associated with anxiety symptoms in patients with ulcerative colitis (UC), and to provide evidence for early identification and intervention. Methods This retrospective study included 104 patients with UC admitted to the First Affiliated Hospital of Henan University from November 2022 to November 2025. Based on the Hamilton Anxiety Scale (HAMA), patients were divided into an anxiety group (HAMA total score ≥14, n=42) and a non-anxiety group (HAMA total score <14, n=62). Clinical information were collected for both groups, including the Pittsburgh sleep quality index (PSQI) score and serum brain-derived neurotrophic factor (BDNF) level. Multivariate logistic stepwise regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify factors associated with anxiety symptoms in patients with UC. Results There were statistically significant differences between the two groups in sex, disease activity, lesion extent, PSQI score, and serum BDNF level (P<0.05). Multivariate logistic regression analysis showed that female sex, severe disease activity, lesion extent of E3 type, and higher PSQI score were independent risk factors for anxiety symptoms in patients with UC, whereas higher serum BDNF level was an independent protective factor (P<0.05). ROC curve analysis showed that both PSQI score and serum BDNF level could be used to assess anxiety symptoms in patients with UC, with area under the curve values of 0.780 and 0.929, respectively (both P<0.05). Conclusion Sex, disease activity, lesion extent, PSQI score, and serum BDNF level are associated with anxiety symptoms in patients with UC. Clinically, greater attention should be given to female patients, those with severe disease activity, extensive lesions (E3 type), PSQI score ≥8.996, and serum BDNF level ≤14.792 μg/L, and psychological intervention should be initiated when necessary.

Key words: colitis, ulcerative, anxiety, disease activity, sleep disorders

CLC Number:

R574.62

Zhang Zhishuang, Wang Fengnan, Wei Fangyuan, Cao Zhenzhen. Clinical factors associated with anxiety symptoms in patients with ulcerative colitis[J]. Clinical Focus, 2026, 41(7): 602-607.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.07.004

https://www.lchc.cn/EN/Y2026/V41/I7/602

Figures/Tables 4

References 23

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项目	焦虑组(n=42)	非焦虑组(n=62)	t/χ²值	P值
性别[例(%)]
男女	16(38.10) 26(61.90)	40(64.52) 22(35.48)	7.033	0.008
年龄(岁)	45.28±8.73	44.05±8.61	0.711	0.479
BMI(kg/m²)	22.15±1.18	21.84±1.37	1.214	0.228
病程(年)	5.22±1.42	4.87±0.97	1.495	0.138
病程中复发次数(次)	2.52±1.13	2.46±1.02	0.282	0.779
吸烟史[例(%)]	5(11.90)	13(20.97)	1.437	0.231
饮酒史[例(%)]	4(9.52)	11(17.74)	1.370	0.242
既往腹部手术史[例(%)]	2(4.76)	3(4.84)	0.202	0.653
婚姻状况[例(%)]
已婚未婚或离异	30(71.43) 12(28.57)	46(74.19) 16(25.81)	0.097	0.755
受教育程度[例(%)]
初中及以下高中及以上	18(42.86) 24(57.14)	20(32.26) 42(67.74)	1.213	0.271
疾病活动度[例(%)]
轻中度重度	19(45.24) 23(54.76)	42(67.74) 20(32.26)	5.229	0.022
肠外表现[例(%)]
关节痛	7(16.67)	8(12.90)	0.287	0.592
口腔溃疡	5(11.90)	6(9.68)	0.131	0.717
病变范围[例(%)]
E1直肠型	5(11.90)	15(24.19)
E2左半结肠型	13(30.95)	28(45.16)	7.500	0.024
E3广泛结肠型	24(57.15)	19(30.65)
PSQI评分(分)	10.85±2.73	7.23±2.15	7.547	<0.01
红细胞沉降率(mm/1 h)	28.52±6.20	26.83±6.59	1.314	0.192
生物制剂使用[例(%)]	8(19.05)	9(14.52)	0.376	0.540
SSRS评分(分)	43.83±7.87	45.08±7.37	0.826	0.411
CRP(mg/L)	24.35±3.87	23.08±3.45	1.753	0.083
Hb(g/L)	117.52±20.33	120.81±16.78	0.900	0.370
BDNF(μg/L)	12.38±2.15	17.24±3.02	8.993	<0.01

项目	焦虑组(n=42)	非焦虑组(n=62)	t/χ²值	P值
性别[例(%)]
男女	16(38.10) 26(61.90)	40(64.52) 22(35.48)	7.033	0.008
年龄(岁)	45.28±8.73	44.05±8.61	0.711	0.479
BMI(kg/m²)	22.15±1.18	21.84±1.37	1.214	0.228
病程(年)	5.22±1.42	4.87±0.97	1.495	0.138
病程中复发次数(次)	2.52±1.13	2.46±1.02	0.282	0.779
吸烟史[例(%)]	5(11.90)	13(20.97)	1.437	0.231
饮酒史[例(%)]	4(9.52)	11(17.74)	1.370	0.242
既往腹部手术史[例(%)]	2(4.76)	3(4.84)	0.202	0.653
婚姻状况[例(%)]
已婚未婚或离异	30(71.43) 12(28.57)	46(74.19) 16(25.81)	0.097	0.755
受教育程度[例(%)]
初中及以下高中及以上	18(42.86) 24(57.14)	20(32.26) 42(67.74)	1.213	0.271
疾病活动度[例(%)]
轻中度重度	19(45.24) 23(54.76)	42(67.74) 20(32.26)	5.229	0.022
肠外表现[例(%)]
关节痛	7(16.67)	8(12.90)	0.287	0.592
口腔溃疡	5(11.90)	6(9.68)	0.131	0.717
病变范围[例(%)]
E1直肠型	5(11.90)	15(24.19)
E2左半结肠型	13(30.95)	28(45.16)	7.500	0.024
E3广泛结肠型	24(57.15)	19(30.65)
PSQI评分(分)	10.85±2.73	7.23±2.15	7.547	<0.01
红细胞沉降率(mm/1 h)	28.52±6.20	26.83±6.59	1.314	0.192
生物制剂使用[例(%)]	8(19.05)	9(14.52)	0.376	0.540
SSRS评分(分)	43.83±7.87	45.08±7.37	0.826	0.411
CRP(mg/L)	24.35±3.87	23.08±3.45	1.753	0.083
Hb(g/L)	117.52±20.33	120.81±16.78	0.900	0.370
BDNF(μg/L)	12.38±2.15	17.24±3.02	8.993	<0.01

变量	回归系数	标准误	Waldχ²值	P值	OR值	95%可信任区间
性别	1.201	0.419	8.214	0.004	3.325	1.462~7.562
疾病活动度	1.410	0.546	6.679	0.010	4.097	1.406~11.938
病变范围	0.684	0.275	6.185	0.013	1.982	1.156~3.398
PSQI评分	1.180	0.390	9.164	0.002	3.255	1.516~6.989
BDNF	-0.311	0.093	11.183	0.001	0.733	0.611~0.879

变量	回归系数	标准误	Waldχ²值	P值	OR值	95%可信任区间
性别	1.201	0.419	8.214	0.004	3.325	1.462~7.562
疾病活动度	1.410	0.546	6.679	0.010	4.097	1.406~11.938
病变范围	0.684	0.275	6.185	0.013	1.982	1.156~3.398
PSQI评分	1.180	0.390	9.164	0.002	3.255	1.516~6.989
BDNF	-0.311	0.093	11.183	0.001	0.733	0.611~0.879

指标	曲线下面积	标准误	P值	95%可信任区间	最佳截断值	敏感度	特异度
PSQI评分	0.780	0.049	<0.01	0.683~0.877	8.996	0.667	0.855
BDNF	0.929	0.025	<0.01	0.880~0.977	14.792	0.786	0.984