This article is a report of the authors' experience with a series of forty-six patients with Crohn's disease seen in psychiatric consultation over a nine year period. We treated twenty-two of these patients in either long term or short term psychotherapy in addition to the initial psychiatric evaluation. A brief literature review of previous studies on the psychiatric aspects of Crohn's disease is also presented. The most common reason that psychiatric consultation was requested was depression, followed by pain and narcotic-related problems. Factors which appeared to contribute to psychiatric morbidity were the following: duration of Crohn's disease, frequent hospitalizations and surgical procedures, presence of an ostomy, history of proctocolectomy, current psychosocial stress unrelated to Crohn's disease and a history of traumatic childhood experiences. Four suggestions regarding psychiatric management of this group of patients are presented and discussed.