WEDNESDAY, Oct. 8 (HealthDay News) -- Wall Street's roller coaster ride is costing Americans more than money: It's costing them sleepless nights and a heap of emotional distress, experts say.

"People are anxious, and they are more anxious if they are nearer retirement age and have their 401k in the stock market and money in the banks," said Linda Rosenberg, president of the National Council for Community Behavioral Healthcare, in Washington, D.C. "When people get anxious . . . it begins to affect the whole family. There are marital fights over 'What do we do now?' Kids get involved when parents are fighting and have their own emotional upset."

In some ways, the current upset may hit closer to home than 9/11, affecting larger numbers of people, added Rosenberg, who reported that mental health centers are getting more calls.

"This economic crisis has been going on for months and months and months," said Josh Klapow, an associate professor of health-care organization and policy at the University of Alabama at Birmingham. "If you take the gas prices, and you couple that with home foreclosures, and you couple that with major lending agencies and investment banks going under and retail prices going up, and you couple that with a stock market that crashes plus a bailout followed by a stock market crash, you get anxiety compounding anxiety."

The uncertainty of even top leaders not knowing when the situation is going to be fixed, not to mention the lack of control many people feel, is only aggravating the matter.

Wall Street workers are probably feeling the pain even more.

"I'm seeing a lot of sleep issues, people with gastrointestinal illness and chronic stomach issues, and people who are sicker in terms of colds and coughs and immune issues," said Kenneth Ruge, a staff minister and counselor at Marble Collegiate Church in New York City who also has many clients on Wall Street. "I'm seeing more Xanax and Ambien for sleep aids and anxiety control. The levels of alcohol consumption, I think, are up somewhat among some of my clients."

A recently released poll found that Americans are indeed more stressed than they were in the spring.

But there may be a silver lining in this cloudy sky. Experts have the following advice to help cope and lessen anxiety:

• Frank Farley, a professor of psychological studies in education at Temple University, said the four "C's" can help people cope. Stay calm. "Don't panic. People who panic do very dangerous things in their life," Farley advised. "Some amount of anxiety is healthy, because it motivates you to do things, but too much anxiety can interfere with your ability to think straight. Be cautious and careful and have confidence. "We have gone through financial crises and recessions, and we have always come out of them," Farley said. "Have confidence that we will again. It's that confidence multiplied 300 million times that will get us out of this. This whole meltdown to a large and significant degree is fueled by psychology."
• Take media reports with a hefty dose of salt. "I sure wish some of the pundits would shut up," Farley said. "We have the specter of the Great Depression, and it fuels fear and panic. This nation has survived incredible things." Ruge reported that many clients are going on a "media fast," refusing to read or watch news reports and refraining from checking the stock market averages except occasionally.
• Do something. "Translate your worries into action," Klapow recommended. "Any small action that will control some of your finances will be very productive for reducing anxiety. Focus on what you can do."
• Maintain a life balance. "If you become consumed with all of the financial information coming out, you will drive yourself physically and emotionally into the ground," Klapow said. "It's important to eat right, engage in pleasurable activities, and strike a balance between attention paid to the financial crisis and attention paid to your well-being."
• Take stock of your life. "It's time to reassess how you handle money and how you handle your life," Farley said. "If you get laid off or have a reduction in hours, maybe this is a time to consider, are you happy in this line of work anyway?" Farley said.

More information

The American Academy of Family Physicians   has more on coping with stress.

TUESDAY, Oct. 7 (HealthDay News) -- Severely brain-damaged patients in a "minimally conscious state" may still feel pain and require painkilling treatment, according to European researchers.

A minimally conscious state (MCS) is different than a persistent vegetative state (PVS), which involves wakefulness without awareness of self or surroundings. MCS patients do show some evidence of awareness of self and their surroundings.

However, caregivers have difficulty assessing MCS patients' levels of conscious pain based on their behavior, according to background information in the study by Dr. Steven Laureys, of the Coma Science Group at the University of Liege, Belgium, and colleagues.

They compared brain activity following electrical stimulation of the median nerve in five MCS patients (ages 18 to 74), 15 PVS patients (ages 18 to 75), and 15 healthy people (ages 19 to 64). The researchers focused on brain areas responsible for pain sensation (the cortical pain matrix), including the thalamus, the primary somatosensory cortex, and the insular, frontoparietal and anterior cingulate cortices.

The MCS patients showed the same level of activity in these areas as healthy people and significantly more activity than PVS patients. The MCS patients also showed better "connectivity" between different brain regions responsible for pain than PVS patients.

"These findings might be objective evidence of a potential pain perception capacity in patients with MCS, which supports the idea that these patients need painkilling treatment," the researchers concluded.

The study was published online by The Lancet Neurology and was expected to be in the November print edition of the journal.

"Increased understanding of the neural processing that can take place in the absence of the conscious awareness, and the patterns of neural activity that are associated with volitional action and conscious experience will undoubtedly shed light on the mechanistic differences among the highly heterogeneous, but functionally restricted, population of patients with disorders of consciousness," Dr. John Whyte, of the Moss Rehabilitation Research Institute in Elkins Park, Pa., wrote in an accompanying comment.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about traumatic brain injury.

TUESDAY, Oct. 7 (HealthDay News) -- The risk and number of errors during biopsy analysis can be drastically reduced by instituting labeling systems for specimen bottles, a new study says.

The Mayo Clinic in Rochester, Minn., which conducted the study, is proposing that busy labs add radio-frequency identification (RFID) tags to track and automate identification of biopsy specimens taken during gastrointestinal endoscopic procedures.

RFID tags, which are commonly such used in libraries or on passports, can be applied to or incorporated into an object so that it can be identified by using radio waves. This is its first application to track specimens in a health-care setting.

The study and proposal were expected to be presented Tuesday at the American College of Gastroenterology annual meeting, in Orlando, Fla.

"The Gastroenterology and Colorectal Surgery outpatient endoscopy unit at our facility yields over 30,000 specimen bottles that are sent for pathologic review every year," study author Dr. Dawn Francis, a gastroenterologist at Mayo Clinic, said in a clinic news release. "Over the past several years, Mayo Clinic identified some issues with mislabeling of tissue specimens in the units. Most labeling errors have been due to either the wrong patient label or no label being affixed to a specimen bottle. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors."

Mayo Clinic researchers drew their conclusions in a review of specimen-labeling errors at their facility in three months before and after the implementation of RFID specimen labeling there. Prior to the new system, 765 errors occurred out of 8,231 specimen bottles sent to the pathology laboratory for evaluation. The error total plummeted, to 47 out of 8,539 bottles, after the RFID plan was instituted.

"It appears that this quality initiative, with emphasis on correct data creation and transcription point reduction, has the potential to significantly improve our clinical practice," Dr. Schuyler Sanderson, a pathologist involved in the research, said in the news release.

More information

The National Cancer Institute has more about gastrointestinal cancer.

TUESDAY, Oct. 7 (HealthDay News) -- Few doctors are adequately prepared to help patients navigate newer, so-called "consumer-directed" health plans, a new survey finds.

The plans, which are meant to shift more responsibility for health care decisions to the individual patient, often come with high deductibles and include a health savings account.

But 43 percent of doctors said they have heard little, if anything, about these plans, and less than half (48 percent) feel ready to discuss medical budgeting with their patients.

"I think as these plans roll out, it's really important to educate doctors about (them) and about some of the differences between these plans and more traditional models of insurance," said study co-author Dr. Craig Pollack, a Robert Wood Johnson Foundation clinical scholar at the University of Pennsylvania in Philadelphia.

The study highlights doctors' nebulous role in counseling patients on financial matters.

"I don't think it's at all clear in insurers' minds what role they want doctors to play, and I don't think physicians themselves are clear on what they're comfortable with," said Dr. Hoangmai H. Pham, a senior health researcher at the Center for Studying Health System Change in Washington, D.C..

Nor do patients know what role they want their doctors to play, she added. "It's frankly very uncomfortable for both patients and physicians to talk about money in any clinical context."

Peter V. Lee, executive director for national health policy at the Pacific Business Group on Health and co-chair of the Consumer-Purchaser Disclosure Project, said the study raises issues that go well beyond consumer-directed health plans.

"Patients under virtually every plan are seeing huge financial implications of their choices," he said, "and historically doctors have felt they didn't need to talk money."

An estimated 5.5 million Americans are enrolled in consumer-directed health plans, according to the 2008 Employer Benefits Survey, an annual report released last month by the Kaiser Family Foundation and the Health Research & Educational Trust.

These plans have grown in recent years as employers have sought ways to shift more responsibility for medical decision-making to employees and their families. The theory is that enrollees will forgo unnecessary services and shop for needed care based on price and quality.

But consumer-directed health plans are not like the managed care arrangements that have dominated the insurance landscape in recent years.

With the exception of some preventive-care services, coverage typically begins after the member satisfies a high deductible -- upwards of $1,500 -- on average, for an individual, according to the Kaiser survey. The high-deductible plan is paired with either a health savings account or a health reimbursement arrangement, and funds in these accounts can be used to pay for routine medical expenses.

To assess physicians' readiness to engage patients on cost and quality issues in these plans, Pollack and colleagues conducted a random, national survey of 1,500 primary-care physicians and received 528 responses.

About one-third of the doctors surveyed had little knowledge about how money is contributed (35 percent) and spent (31 percent) from the plans' medical savings accounts.

Being exposed to these plans did not always mean that doctors were in the know.

"We were surprised that about a quarter of physicians who currently knew that they cared for patients in consumer-directed health plans said they really didn't have a lot of knowledge about the cost-sharing involved in these plans," Pollack said.

While most felt ready to discuss the cost of office visits, medications and laboratory tests, half or fewer were prepared to advise patients about the cost of radiologic studies, specialist consultations and hospitalizations.

People enrolled in consumer-directed health plans are encouraged to take advantage of online tools to compare costs and evaluate quality when making medical decisions. But, according to the survey, physicians are deeply skeptical about the information provided by government and insurance Web sites.

Only 8 percent believed that patients could trust the information provided on insurers' Web sites.

"If there's going to be a lot of pushback on the part of the doctors, I think it could lead to consternation on the part of the patients," Pollack said.

More information

There's more on consumer-directed health plans at the Henry J. Kaiser Family Foundation  .