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BACKGROUND Psychodermatoses and their associations with mental health problems are one of the most frequent research themes in dermatology out-patient settings. Surprisingly however, very few studies have been conducted to evaluate psychodermatoses among subjects with primary psychiatric disorders. As such, the relationship between pre-existing psychiatric disorders and co-morbid psychodermatoses are underrepresented in literature. OBJECTIVE Aims This study examined the prevalence and distribution spread of psychodermatoses among adults with primary psychiatric disorders and determined the association between psychodermatological disorders and underlying psychiatric diagnosis. METHODS A cross-sectional analytical study involving 107 adult psychiatric patients was conducted at a tertiary healthcare facility in Southwestern Nigeria. Co-morbid psychodermatological disorders (PDs) were identified and classified using pre-existing classification systems. Bivariate analysis was conducted to determine the association between psychodermatoses and underlying psychiatric disorders. The level of statistical significance was set at p < 0.05. RESULTS Seventy-five (70.1%) of mental-health patients had at least one co-morbid psychodermatoses. The prevalence of psychodermatoses was highest in patients with affective disorders (75%) and least in those with schizophrenia(68.2%). PDs resulting from delusions/hallucinations (PDDH) and somatoform PPDMS were 9 and 13 times more frequent in patients with anxiety disorders compared with other psychiatric disorders (p= 0.013 and 0.003 respectively) In contrast, patients with schizophrenia were significantly less likely to be diagnosed with PDDH (p=0.002) A weak but significant negative association was also found between psychophysiological PDs and anxiety disorders (phi = -0.236, p=0.015). CONCLUSIONS This study provides important insights into the overwhelming burden of psychodermatological conditions in mental health patients and specific associations with underlying psychiatric diagnosis. CLINICALTRIAL IRC/IEC/00045553