The aim of this study was to evaluate the association between anxiety and depression, and levels of disease activity (LDA) in IBD patients. One hundred and fifty IBD patients (91 males and 59 females) were assessed by means of the Hospital Anxiety and Depression scale, and divided into three LDA groups according to standard clinical criteria: LDA1 = absence, LDA2 = mild, LDA3 = moderate and severe. Using the analysis of variance and the Scheffé test, a significant difference was found in the anxiety score, but not in the depression score, between LDA1 and LDA3 (p < 0.005). The risk of developing anxiety and depression in relation to LDA was estimated by multiple logistic regression. A significant linear trend (p < 0.01) to develop anxiety was found in the highest LDA. Our study showed that anxiety was significantly associated with a higher disease activity and suggested that anxiety should be appropriately evaluated and treated with the exacerbated symptoms in IBD patients.