OBJECTIVES: To assess incremental burden of cardiovascular (CV) comorbidity or psoriatic arthritis (PsA) among individuals with moderate-to-severe psoriasis (PsO) in Europe. METHODS: All measures were self-reported and came from the 2010-2013 EU National Health and Wellness Surveys (NHWS), cross-sectional surveys of adults in France, Germany, Italy, Spain, and the UK. Moderate-to-severe PsO respondents were identified by >10% body surface area affected by PsO and/or use of therapies for moderate-to-severe disease.  Respondents were compared according to the presence of CV comorbidity or PsA.  Outcomes were SF-12v2/SF-36v2 mental and physical component summary scores (MCS & PCS, respectively), SF-6D health utility, Work Productivity and Activity Impairment (WPAI) questionnaire, and healthcare use in the past 6 months. Generalized linear models compared across CV or PsA groups vs. non-CV or non-PsA groups with appropriate link functions to adjust for covariates (sociodemographics & length of illness). RESULTS: Among moderate-to-severe PsO respondents (n=957), 19.8% (n=190) reported physician-diagnosed CV comorbidity, and 12.3% (n=118) reported PsA. After adjustment for covariates, CV respondents had decrements of 2.9 points for MCS, 3.2 points for PCS (minimally important difference [MID] =3.0 for both), and 0.05 points for SF-6D (MID=0.03) relative to non-CV respondents (all p<0.01).  Likewise, they had greater mean work impairment (47% vs. 33%), more activity impairment (48% vs. 38%), more healthcare provider visits (8.7 vs. 7.0), emergency room visits (0.62 vs. 0.32), and hospitalizations (0.57 vs. 0.23) (all p<0.05).  Compared to non-PsA respondents, PsA respondents also had worse mean MCS (2.6 points), PCS (6.3 points), and SF-6D scores (0.07 points), more work impairment (52% vs. 34%), activity impairment (54% vs. 38%), and healthcare provider visits (10.5 vs. 6.9) (all p<0.05). CONCLUSIONS: Moderate-to-severe PsO patients with CV comorbidity or PsA in Europe reported significantly greater burden, with decrements in physical health status and health utility exceeding the minimally important differences for these measures.