472 Association of psoriasis with alcohol use disorder: A case-control study in the all of us research program

There exists a complex association between psoriasis and psychiatric comorbidities such as depression, anxiety, and alcohol use disorder (AUD). Here, we sought to examine the association of psoriasis with AUD in the All of Us (AoU) database. We performed a case-control study of the AoU database, comprising a diverse group of adults in the United States (2018-2022). Participants with psoriasis were identified using International Classification of Diseases (ICD-9 and ICD-10) codes. Nearest neighbor matching was used to pair five adult controls to each case based on age, sex, and race/ethnicity. We performed univariate regression to identify covariates significantly (p<0.05) associated with AUD and applied a multivariate logistic regression model adjusting for these covariates. We identified 6,466 adults with psoriasis (mean age, 61.7 years; SD, 15.1; 58.8% women, 38.0% men) and 32,330 matched controls. Anxiety was more prevalent among cases (47.2%) than controls (24.8%). Depression was also more prevalent among cases (44.1%) than controls (24.6%). In a multivariate model adjusting for covariates (age, sex, race/ethnicity, tobacco use, anxiety, depression, education, income), we identified a significant association between psoriasis and AUD (OR 1.18 [1.04-1.34], p=0.012). We found that adults with psoriasis had a 1.18-fold increase in odds of having comorbid AUD compared to controls, independent of depression and anxiety, suggesting the importance of screening for alcohol consumption in this population. The reason for this is not known but may be related to the psychosocial impact of psoriasis. Alternatively, it may reflect shared environmental, genetic, or epigenetic factors in the development of AUD and psoriasis. Limitations of this study include selection bias and inability to assess causality.