Psychological disturbances seem to be a consequence of the illness rather than the cause or specific to Crohn's disease. The degree of psychological distress correlates with the disease severity and predicts health related quality of life. Its influence upon the course of disease remains controversial [EL1b, 2b and 3b, RG B].

An association between psychological factors and the aetiology of Crohn's disease is unproven [EL3b, 4, RG D] and the role of psychological factors on the disease course is controversial [EL1b, 2b, RG B].

An association between psychological factors and the aetiology of Crohn's disease is unproven [EL3b, 4, RG D] and the role of psychological factors on the disease course is controversial [EL1b, 2b, RG B].

It remains unclear whether acute life events trigger relapses [EL1b,2b, RG B] Most patients consider stress to have an influence on their illness [EL2c,3, RG C].

The psychosocial consequences and health-related quality of life of patients should be taken into account in clinical practice at regular visits. Individual information and explanation about the disease should be provided through a personal interview. The course of the disease can be improved by combining self-management and patient-centred consultations [EL1b,3b, RG B].

Physicians should assess the patient's psychosocial status and demand for additional psychological care and recommend psychotherapy if indicated. Integrated psychosomatic care should be provided in IBD centres [EL2b, RG B].

Patients should be informed of the existence of patient associations [EL 5, RG D].

Psychotherapeutic interventions are indicated for psychological disorders, such as depression, anxiety, reduced quality of life with psychological distress, as well as maladaptive coping with the illness [EL1b,2b,3b, RG B].

The choice of psychotherapeutic method depends on the psychological disturbance and should best be made by specialists (Psychotherapist, Specialist for Psychosomatic Medicine, Psychiatrist). Psycho-pharmaceuticals should be prescribed for defined indications [EL5, RG D].

There is no conclusive evidence for anxiety, depression and psychosocial stress contributing to risk for UC onset [EL2c, RG D]

Psychological factors may have an impact on the course of UC. Perceived psychological stress [EL2a, RG B] and depression [EL2a, RG B] are risk factors for relapse of the disease. Depression is associated with low health-related quality of life [EL3a, RG B]. Anxiety is associated with non adherence with treatment [EL4, RG C]

Psychological distress and mental disorder are more common in patients with active ulcerative colitis than in population-based controls, but not in patients in remission [EL3a, RG B]

Clinicians should particularly assess depression among their patients with active disease and those with abdominal pain in remission [EL 2b, RG B]

The psychosocial consequences and health-related quality of life of patients should be taken into account in clinical practice at regular visits. Individual information and explanation about the disease should be provided through a personal interview [EL3b, RG B]. Patients' disease control can be improved by combining self-management and patient-centred consultations [EL1b, RG B]

Physicians should screen patients for anxiety, depression and need for additional psychological care and recommend psychotherapy if indicated [EL 2b, RG B]. Patients should be informed of the existence of patient associations [EL 5, RG D]

Psychotherapeutic interventions are indicated for psychological disorders and low quality of life associated with ulcerative colitis [EL 1b, RG B]

The choice of psychotherapeutic method depends on the psychological disturbance and should best be made by specialists (Psychotherapist, Specialist for Psychosomatic Medicine, Psychiatrist). Psychopharmaceuticals should be prescribed for defined indications [EL 5, RG D]