Bakgrund: Globalt sett är depression det sjukdomstillstånd som står för störst sjukdomsbörda mätt i år förlorade till sjukdom. Incidensen av depression i världen har ökat med 49 % från 1990 till 2017 och forskning har visat ett samband mellan kön och ålder samt depression. Motiv: Det finns bristande kunskap om vad som kännetecknar personer med nedstämdhet. Det är oklart om de samband som finns gällande funktionsnedsättning och depression även har ett samband gällande nedstämdhet. En ökad kunskap hos distriktssköterskor om kännetecken för nedstämdhet hos äldre kan förväntas leda till att detta tillstånd identifieras både tidigare och bland fler personer. Syfte: Syftet med denna studie var att identifiera kännetecken på nedstämdhet hos äldre personer i särskilt boende. Metod: Data till denna studie har inhämtats från en longitudinell studie (Äldre vårdade på institution i Västerbotten) och består av data från instrumentet MultiDimensional Dementia Assessment Scale (MDDAS). Studien riktades mot personer boendes i särskilda boenden för äldre i Västerbotten i maj 2013. Totalt besvarades 2210 enkäter (svarsfrekvens 70,1 %). Chi2-analys användes för att identifiera variabler med statistiskt signifikanta samband med nedstämdhet. En stegvis logistisk regressionsanalys användes för att skapa en förklaringsmodell. Resultat: Resultatet visar att aggressivitet, verbalt störande eller uppmärksamhetssökande beteende, hallucinationer, smärta samt kvinnligt kön var förknippat med en ökad sannolikhet för förekomst av nedstämdhet. Det visar även att ålder var en skyddsfaktor i detta sammanhang. Modellen förklarade 6,7-12,6 % av variationen. Konklusion: Distriktssköterskor har en viktig roll när det gäller att identifieranedstämdhet hos äldre, vilket vårt resultat kan bidra till. / Background: Globally, depression is the medical condition with the highest burden of disease measured in years lost to illness compared to all diseases. The incidence of depression in the world has increased with 49 % from 1990 until 2017, and research shows a correlation between sex, age and depression. Motive: There is a lack of knowledge about what characterizes people with minor depression. It is not clear whether the existing association between disability and depression also are related to minor depression. Increased knowledge of characteristics of minor depression in the elderly among district nurses can be expected to lead to the condition being identified earlier and among more people. Aim: The aim of this study was to identify signs of minor depression in elderly persons living in elder care facilities. Methods: Data for this study was obtained from a longitudinal survey and consisted of data from the Multi-Dimensional Dementia Assessment Scale (MDDAS). It was aimed at persons living in elder care facilities in Västerbotten in May of 2013. In total, 2210 surveys were answered with a response rate of 70,1 %. Chi2-analysis were used to identify variables with a statistically significant relationship with minor depression. In addition, a step-wise logistic regression analysis was used to create a model of explanation. Result: The result shows that aggressiveness, verbally disruptive or attention-seeking behaviour, hallucinations, pain and female sex were associated with an increased chance probability of minor depression. It also shows that age was a protective factor in this context. The model explaineds 6,7-12,6 % of the occurence of minor depression. variance.  Conclusion: District nurses have an important role in identifying minor depression in older people, which our result can contribute to.

The doctoral dissertation: Searching for pathomechanisms of late-life minor depression – a combined MRI, biomarker and meta-analytic study was one of the first studies investigating the underlying pathophysiology of minor depression. The dissertation comprises a systematic review of the prevalence rates of minor depression, two meta-analyses of peripheral BDNF changes in major depressive disorder, as well as two original studies investigating serum BDNF, S100B and NSE levels and gray matter changes in minor depression. The limitations of studies and proposed improvements to the study design are discussed extensively.:1. INTRODUCTION 1.1 Motivation 1.1.1 Minor depression in the spectrum of psychiatric disorders 1.1.2 Minor depression is prevalent but unrecognized. 1.2 Theoretical background 1.2.1 Overview of depression hypotheses 1.2.2 Neurotrophic hypothesis of depressive disorders 1.2.3 Glial hypothesis of depressive disorders 1.2.4 Structural neuroimaging changes in major depression 1.3. Rationale and hypotheses of the empirical studies 1.3.1 Research questions 1.3.2 Research hypotheses 2. EMPIRICAL STUDIES 2.1 The prevalence of minor depression in the late life 2.2 The meta-analysis of BDNF changes in mood disorders 2.3 The meta-analysis of BDNF changes following ECT in depression 2.4 Serum biomarkers in minor depression 2.5 Structural brain imaging in minor depression 3. GENERAL DISCUSSION 3.1 Summary of results 3.2 Implications for research 3.3 Implications for clinical studies SUMMARY REFERENCES APPENDIX A: DECLARATION OF CONTRIBUTION APPENDIX B: STATEMENT OF AUTHORSHIP APPENDIX C: CURRICULUM VITAEAPPENDIX D: ACADEMIC CONTRIBUTIONS APPENDIX E: ACKNOWLEDGMENT