OBJECTIVES: To evaluate clinical and psychological burden of psoriasis (PsO). METHODS: A retrospective analysis of data from patients with a diagnosis of PsO (ICD-9 code 696.1) from Jan. 1, 2000 to June 30, 2005 was conducted with the PharMetrics database. A randomly selected, age- and gender-matched controls of non-PsO claimants was the comparator. Patients were enrolled for 6 months pre- and 12 months post-PsO diagnosis and have 2 distinct claims for PsO. Rates of comorbidities were derived for patients in the 12 months following their initial PsO diagnosis. Multivariable logistic regression was used to determine the association between PsO and clinical and psychological comorbidities. RESULTS: Among a cohort of 121,387 patients, 24,256 patients had a PsO diagnosis. PsO patients had higher rates of depression, use of SSRI, and cardiovascular comorbidities or risk factors (defined as coronary artery disease, hypertension, hyperlipidemia, and diabetes mellitus) compared with those without PsO (7.8% vs 5.1%, 14% vs 8.3%, and 37% vs 27% respectively). The multivariate analysis showed that patients with PsO have a higher disease burden than that of controls. The odds ratios (OR) for depression, coronary artery disease, hypertension, hyperlipidemia, diabetes, COPD, obstructive sleep apnea, alcoholic hepatitis, melanoma, and hospitalization for pneumonia were 1.52, 1.48, 1.47, 1.49, 1.22, 1.52, 1.81, 2.50, 2.22, and 1.35, respectively. The increased ORs for cardiovascular risk factors (e.g., hypertension and hyperlipidemia) were also associated with PsO, which is consistent with a trend shown in patients with severe PsO compared with patients with mild PsO in the UK General Practice Research Database of 127,706 patients (Neimann, et al. J Am Acad Dermatol; 2006;55:829-835). CONCLUSION: Clinical (including cardiovascular risk factors) and psychological disease burden among patients with PsO is greater than that for patients without PsO.