Abstract
BACKGROUND: Ulcerative colitis (UC) is often accompanied by depressive symptoms, yet the association between disease activity and depression remains insufficiently characterized. OBJECTIVE: To evaluate the correlations between SCCAI scores, Mayo endoscopic severity scores, and QIDS-SR16 depression scores in patients with UC. METHODS: This cross-sectional study included 106 hospitalized UC patients from January 2023 to December 2024. Disease activity was assessed using the Simple Clinical Colitis Activity Index (SCCAI), and endoscopic severity was assessed with the Mayo score in a subsample (n = 54). Depressive symptoms were evaluated using QIDS-SR16. Multivariable linear regression and restricted cubic spline models were applied to examine linear and nonlinear associations. RESULTS: A 1-point increase in SCCAI score was associated with a 0.41-point increase in QIDS-SR16 score (β = 0.41, 95% CI: 0.19-0.63, P < 0.001). A 1-point increase in the Mayo score corresponded to a 1.07-point increase in QIDS-SR16 (β = 1.07, 95% CI: 0.24-1.90, P = 0.015). Restricted cubic spline analysis revealed a nonlinear association between SCCAI and QIDS-SR16, with greater sensitivity of depressive symptoms at lower SCCAI levels. CONCLUSION: In this cross-sectional real-world study, both clinical disease activity (SCCAI) and endoscopic severity (Mayo score) were independently and positively correlated with depressive symptom burden in UC patients. These findings support incorporating routine depression screening into UC clinical management to facilitate timely detection and intervention.