In approximately what percent of your patients have you noticed symptoms of depression?

How prevalent are symptoms of depression?

• Nearly 40% of clinicians noticed depression symptoms in at least 40% of their patients
• Over 90% of clinicians noticed symptoms in at least 20% of their patients
• Depression affects almost 10% of the population, or 19 million Americans, in a given year (According to the National Institutes of Health)

For your patients that show symptoms of depression, please estimate the percent with whom you have discussed treatment options.

Are clinicians discussing treatment options with depressed patients?

• 75% of clinicians have discussed treatment with at least 40% of their patients

How likely are you to discuss depression with men compared to women?

Does gender play a role in discussing depression?

• 30% of clinicians report being less likely to discuss depression with men
• Clinicians say it is more difficult to treat men because they are less “open” than women, and more resistant to addressing depression
• The rate of suicide in men is four times that of women (National Institute of Mental Health)

To what extent do you agree or disagree that physicians are hesitant to diagnose depression?

Are physicians hesitant to diagnose depression?

• More than half of respondents believe physicians are hesitant to diagnose patients with depression

Why do you believe physicians are hesitant to diagnose depression?

Why does depression go undiagnosed?

• Resistance from patients is reported as the leading reason for not diagnosing depression
• More than half of clinicians also reported uncertainty about the diagnosis and concerns about social acceptance
• 17% of respondents believe physicians do not recognize depression as a disease

Note: Respondents may select all that apply

How has the percentage of your patients diagnosed with depression changed in the last five years?

Are Americans more depressed?

• 85% have seen an increase in patients with depression over the past 5 years

Note: No clinicians reported a decrease

Why do you believe there has been an increase in depression among Americans?

Why is there an increase in depression among Americans?

• Greater disease awareness may be leading more patients to seek help
• Greater stress and societal expectations are seen as contributing to depression

Note: Respondents may select up to 3; includes responses >10%

What do you believe are the leading risk factors for depression?

What are risk factors for depression?

• Clinicians rate stress and family history as the leading risk factors for depression
• Nearly 60% of respondents identified other medical illness as a key risk factor for depression

Note: Respondents may select up to 3; includes responses >10%

Have you personally ever experienced depression?

Do clinicians experience depression?

• More than half of clinicians have experienced depression in their lifetime
• Clinicians may experience a higher incidence of depression than the general public, of whom it is estimated that up to 25% of will likely become clinically depressed in their lifetime
• 12% of respondents reported missing work because they felt depressed

What factors do you believe contributed the most to your depression?

What are key contributors to clinicians’ depression?

• Overall, clinicians believe professional stress and personal events are the leading contributors to their depression
• Only 29% of clinicians view family history as a contributor for their depression; however, 78% believe it’s a key factor for their patients

Note: Respondents may select all that apply; includes responses >10%

Do you believe that patients with depression can be cured?

Is depression curable?

• 70% of clinicians believe depression can be cured

What do you recommend for your patients experiencing depression?

What do clinicians recommend for depression?

• While nearly all clinicians primarily recommend therapeutic treatment for patients, the majority also recommend social and lifestyle changes
• 80% of depressed people are not currently receiving any treatment (National Institutes of Health)

Note: Includes responses >10%

What type of impact do you feel the shootings at Virginia Tech had on the public’s perception of depression?

How did the Virginia Tech shootings impact views on depression?

• More than half of clinicians believe the events increased awareness of the disease and/or the disease is more recognized as a mental illness
• Nearly 40% believe it has created fear of people with depression

Note: Respondents may select up to 3

Notes: Depression Survey Background

Survey includes 500 Epocrates clinicians comprising physicians, nurse practitioners and physician assistants.

500 Epocrates clinicians:

300 physicians

100 nurse practitioners

100 physician assistants

Thank you for viewing the results of our depression survey.

We invite you to share your thoughts on the topic and view the opinions of your colleagues in the discussion below. We look forward to sharing new insights from Epocrates users with you in the future.

Which of the following public health issues do you consider “extremely severe” or “severe?”

How Severe is the Obesity Crisis?

• Physicians rank obesity as the most important public health issue, followed by chronic disease, smoking, uninsured population and AIDS
• Bird flu and malnutrition were not viewed as severe public health issues

Approximately what percent of your patients do you consider to be clinically overweight?

What Percentage of Americans are Overweight?

• More than half of physicians believe at least 50% of their patients are clinically overweight
• Nearly 90% of physicians believe this percentage has increased in the last five years
• The American Obesity Association (www.obesity.org) reports 65% of U.S. adults are overweight and 31% are obese

Note: None selected below 10%

For the patients that you consider overweight, please estimate the percent with whom you have discussed weight loss?

Are Physicians Discussing Weight Loss?

• Overall, physicians are likely to discuss weight loss with at least 30% of their overweight patients

Approximately, what percent of your colleagues do you consider to be clinically overweight?

Are Physicians Obese Too?

• Obesity also appears to be an issue among physicians
• Eighty-eight percent of physicians believe at least 30% of their colleagues are overweight

Who do you believe is primarily responsible for
causing and solving the obesity crisis?

Who is Responsible for the Obesity Crisis?

• Overall, physicians primarily view individuals as responsible for obesity; However the food industry was also viewed as a key contributor
• Nearly 20% of physicians view their profession as responsible for helping to address the obesity issue
• While not viewed as responsible for causing the obesity crisis, physicians see a role for government in addressing the issue

Note: “Other” responses omitted

What factors do you believe help motivate obese adults to make lifestyle changes to improve their health?

What Will Drive Lifestyle Changes?

• Physicians view education and fear of long term health risks as factors which will drive lifestyle changes
• New medications are not viewed as a powerful motivator

Note: participants may select all that apply; includes responses above 10%

Which of the following initiatives do you believe will have a significant impact on addressing obesity?

What Initiatives Will Have the Most Impact on Reducing Obesity?

• Physicians rated school focused initiatives as having the highest potential impact
• Physicians are least optimistic about the impact of new OTC drug Alli in reducing obesity

Note: includes responses above 10%

Which factors do you believe contribute the most to obesity?

What are the Leading Causes of Obesity?

• Physicians view lack of physical activity as the leading cause of obesity
• Nearly 60% of physicians view portion size as an important contributing factor to obesity

Note: participants may select two

What do you view as the best weight loss program?

What is the Best Weight Loss Program?

• Physicians rated Weight Watchers and South Beach Diet as the best weight loss programs available (www.weightwatchers.com and www.SouthBeachDiet.com)

Note: participants may select two

Which of the following do you believe to be a health risk for clinically overweight children?

What are the Most Recognized Childhood Obesity Health Risks?

• The majority of physicians were aware of increased health risks such as type 2 diabetes and high cholesterol/blood pressure
• However, many physicians were not aware of the increased risk of liver disease and asthma among obese children

Note: participants may select all that apply

Notes: Obesity Survey Background

Survey includes 580 Epocrates physicians comprising of Primary care physicians, Endocrinologists and Cardiologists.

Primary working regions:

15% Rural

48% Suburban

37% Urban

Primary clinical setting:

51% Group practice

12% Solo practice

12% Academic center

12% Outpatient clinic

11% Hospital

Thank you for viewing the results of our obesity survey

We invite you to share your thoughts on the topic and view the opinions of your colleagues in the discussion below.

• What have you found are the best ways to address the obesity issue with your patients?
• What initiatives have the most chance of helping to reduce the obesity rate?

We look forward to sharing additional insight from Epocrates users with you in the future.

The Epocrates Team