The purpose of the present study was to examine how specific personality traits and/or conflicts could serve to predict nonadaptability after surgical treatment for ulcerative colitis. In order to define the scope of the study and to establish more specific hypotheses, retrospective studies were conducted by in depth interviews with 10 patients. Five of the patients had undergone colectomy with proctomucosectomy and ileal pouch ad modum Parks, and 5 had had a proctocolectomy with ileostomy ad modum Brooke. The interviews were recorded on tape and analyzed by the interviewer as well as by an independent evaluator. In addition, the operating surgeon provided an independent evaluation of the patients' post-operative adaptation. There was good consensus between both sets of assessments based on interviews as well as between the interview diagnoses and the surgeon's evaluation. There was no observed correlation between prevailing psychiatric diagnostic categories and postoperative adaptation. Psychological factors, such as a discrepancy between body image and body ideal, alexithymic characteristics, abnormal aggression patterns, extensive physical exercise and muscular training, showed varying degrees of negative correlation with postoperative adaptation.