People with psoriasis — a chronic autoimmune disease that primarily affects the skin — are at greater risk of depression. This is according to new research recently presented at the American Academy of Dermatology’s 2015 Summer Annual Meeting in New York.

Researchers found people with psoriasis were twice as likely to meet the criteria for major depression than those without the skin disease.

The exact cause of psoriasis is unclear, but researchers believe it may be triggered by the immune system attacking healthy cells — particularly skin cells, causing what is known as plaque psoriasis.

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