S.L., a female student 17-years old, presented to our outpatient clinic in July '92 with diarrhoea and blood per rectum. Colonscopy and histology revealed ulcerative colitis (U.C.) of rectum and sigmoid colon.

The patient has been treated with mesalazine, with good results, except mild proctitis at one year.

At the last clinical control she (and her parents) denied symptoms but anaemia has appeared and colonscopy showed involvement of the entire colon.

Psychological status showed depression, psychastenia, paranoid symptoms, anxiety and regression (Symptom Questionnaire, Illness Behaviour Questionnaire, Eysenck Personality Inventory, M.M.P.I., Draw tests).

Difficulties in treatment of the adolescent patient with U.C. can be due to ambivalence for symptoms by the adolescent and by the parents, which can become negation of it.

This in turn can confound decisions about drug treatment and cause misunderstanding of the clinical course.

Our case record reveals how difficult is the follow-up and treatment of U.C. in adolescents and how crucial is the compliance of the patient and the family.

Our experience highlights the need of an interdisciplinary approach and of reassurance of the patient and his/her parents.

We need more data for a better understanding of the complex interplay between psycho-somatic aspects of the disease.

Key Words: Ulcerative colitis, Compliance, Depression.