Background/Objectives: Psoriasis is a chronic inflammatory skin disease increasingly linked to psychiatric and behavioral comorbidities, including depression, anxiety, and substance use disorders. Shared inflammatory pathways, including elevated IL-6, TNF-α, and IL-17, may link psoriasis with psychiatric disorders such as depression and anxiety. The bidirectional interaction between systemic inflammation and mental health may exacerbate the disease burden and affect treatment outcomes. The objective of this study was to determine the prevalence of psychiatric and behavioral comorbidities in patients with psoriasis and to explore potential demographic and clinical correlations. Assessing these correlations contributes to a better understanding of the mental health status of psoriasis patients, potentially influencing both therapeutic efficacy and quality of life. Methods: We conducted a cross-sectional observational study on 316 patients with clinically and histopathologically confirmed psoriasis, evaluated between January 2021 and March 2025 at the Clinical Railway Hospital in Iași, Romania. Psychiatric and behavioral comorbidities were assessed through clinical interviews, medical record reviews, and standardized tools including AUDIT-C, Fagerström Test for Nicotine Dependence, and the Binge Eating Scale. Psoriasis severity was evaluated using the Psoriasis Area and Severity Index (PASI). Results: Of 316 participants, 88 (27.8%) had psychiatric/behavioral comorbidities. The most frequent conditions were tobacco use disorder (11.1% overall; 39.8% among comorbid patients), alcohol use disorder (9.2%; 32.9%), binge eating (7.9%; 28.4%), anxiety (6.3%; 22.7%), and depression (4.1%; 14.8%). Additional diagnoses included personality disorders, dementia, PTSD, and sleep disorders. Conclusions: Psychiatric and behavioral comorbidities, particularly substance use disorders, are relatively common in patients with psoriasis. These findings support the need for regular mental health screening and integrated care approaches in psoriasis management.
