That Looks to me like it was mostly drawn out, on a piece of paper, and then just scanned in, and added the text to it.
Maybe added a few details in PSP.
The other possibility is that a Pen Tablet was used. In which you have a pen like device on a tablet, and you can draw just like you would on normal paper. Except it gets instantly transferred to PSP.
I would start with a colored drawing scanned into the computer, and then add some text with the Text tool, and a specific font. You can then play around with the background colors, transparencies etc...
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Ignorance is not necessarily Bliss, case in point:
Unknown has caused an Unknown Error on Unknown and must be shutdown to prevent damage to Unknown.
