Compliance with medications is very important in the management of many gastrointestinal disorders: in inflammatory bowel disease (IBD), controlled trials have shown the benefit of prophylactic medical treatment in lowering the risk of recurrences. Our aim was to appraise the association between current psychiatric disorders and medication adherence in an unselected consecutive group of outpatients with IBD. In 85 unselected consecutive outpatients with IBD, a professional structured diagnostic interview and a psychiatric assessment, by the Structured Clinical Interview for Diagnostic and Statistical Manual-III-Reviewed, were carried out. In a stepwise regression analysis, compliance, as dependent variable, correlated positively with disease duration and inversely with both disease severity and presence of psychiatric disorders. In patients with IBD, preventive liaison psychiatry interventions seem indicated.