Health Buzz: Noninvasive Stool Test Could Detect Colon Cancer

A reliable, at-home colon cancer screening test that identifies DNA mutations in stool samples could soon supplement the dreaded colonoscopy. Exact Sciences Corp.'s noninvasive tool is far more predictive of colon cancer than the standard stool blood test because it screens for mutations associated with the presence of tumors. In a study of more than 1,000 patients, the test detected 85 percent of colon cancers, 64 percent of precancerous polyps, and 90 percent of healthy samples, researchers said Thursday at an American Association for Cancer Research conference. About 150,000 people are diagnosed with colon cancer each year, and 50,000 die from the disease annually. Often, that's because people shy away from invasive and somewhat risky colonoscopies until they have symptoms—indicating that the disease may already be advanced, The Wall Street Journal reports. "The noninvasive test we have developed is simple for patients, involves no diet or medication restriction, no unpleasant bowel preparation, and no lost work time, as it can be done from home," David Ahlquist, a Mayo Clinic researcher who helped develop the test, said at the conference. "Positive tests would be followed up with colonoscopy." The tool requires at least another year of development before it's ready for clinical use, researchers said.

Scientists Map 95% Of Human Gene Variations

An international team of scientists has mapped 95 per cent of the genetic variation that can occur in any human, completing the first phase of the 1000 Genomes Project, which aims to produce a comprehensive public resource to help researchers study all types of genetic variation that might cause disease in humans.

The map, and an account of how the consortium behind the project compiled it, appears in a paper published in the 28 October issue of the journal Nature.

Many of the variants had been identified already, but more than half are new: so far 95 per cent of the currently measurable variants in any person have been found, and when completed, the project will have identified more than 99 per cent of all human variants.

The new map also includes some surprises.

For instance, the researchers found that on average, each of us has between 250 and 300 genetic changes that would cause a gene to stop working properly, confirming that none of us has a "perfect" genome. Another surprise was that each person carries between 50 and 100 genetic variations that have already been linked with an inherited disease.

However, because we each carry two copies of a gene, one from each biological parent, the chances are that we stay healthy, as long as one of the copies is ok.

As well as looking at common variants, the researchers looked in detail at the genomes of two families of three members each: mother, father and daughter.

They located new variants in the daughters that were not present in either of their parents. This helped them determine the rate of mutation of DNA in humans, which they worked out to be about 60 new mutations per generation (ie variants that are not passed on from the parents, but are still "faults" compared to the "perfect" genome).

The work was spread across three pilot studies where the researchers used next-generation DNA sequencing technologies to map genetic variation in 180 people.

Cholera death toll nears 300 in Haiti

The death toll from Haiti's cholera outbreak has risen to 292, the Haitian government said Wednesday. There are 4,147 confirmed cases.

Calling Haiti's cholera outbreak "an extremely serious condition," a United Nations official expressed concern Monday that the infectious disease could spread and grow to "tens of thousands of cases."

"It would be careless to plan for anything but a considerably wider outbreak," said Nigel Fisher, U.N. humanitarian coordinator in Haiti.

Officials with the Pan American Health Organization expressed similar concerns about the disease spreading to the Dominican Republic.

CARE has medical teams working around the clock to treat patients in the affected area.

"We also are working in Port-au-Prince, providing hygiene and water purification tablets," CARE spokesman Brian Feagans told CNN.

Missionaries from Tennessee are also doing their part to help contain the cholera outbreak in nearby areas.

"People are aware now; fears are there, but they don't know enough to understand the dangers," Andrea Brewer said.

Sleepiness Might Be in the Genes, Study Finds

No issue how little they sleep, some people can keep a skip in their step while others will yawn and struggle through the day. A new study from the University of Pennsylvania School of Medicine found that the reason could be in our genes.

Researchers found that healthy people with one particular genetic variant were normally sleepier than those without the gene. About 25 percent of the common public has the genetic variant, called DQB1 *0602, but only a little percentage of them actually suffer from sleep problems.

One person who has been told by his doctor that he may have this genetic difference is Robert Gibson, a 43-year-old machine shop supervisor in Milan, Illinois. Sleep is supposed to rejuvenate the body, but for Gibson, it can be anything but invigorating.

It would not be the only gene-linked sleep situation Gibson experiences; he already suffers from bouts of sleep paralysis, a disorder in which sufferers feel paralyzed as they fall asleep or as they wake up. Episodes can last a few seconds to a couple of minutes, but Gibson said the effects of the temporary paralysis seem to bog him down every day.

One-Third of U.S. Adults Could Have Diabetes by 2050: CDC

The number of American adults with diabetes could double or triple by 2050 if present trends continue, warns a federal government study released Friday.

The number of fresh diabetes cases a year will increase from 8 per 1,000 in 2008 to 15 per 1,000 in 2050, predicts the U.S. Centers for Disease Control and Prevention. By 2050, between one-fifth and one-third of all adults could have diabetes -- with virtually all the increase attributed to type 2 diabetes, which is largely preventable.

An aging population, an increase in minority groups at higher risk for diabetes, and the fact that diabetes patients are living longer are among the reasons for the steep projected rise.

"These are alarming numbers that show how critical it is to change the course of type 2 diabetes," Ann Albright, director of CDC's Division of Diabetes Translation, said in an agency news release. "Successful programs to develop lifestyle choices on healthy eating and physical activity must be made more widely available, because the stakes are too high and the personal toll too devastating to fail."

Another expert agreed.

"These data are accurate and reflect reality," said Dr. Mary Ann Banerji, professor of medicine and director of the Diabetes Treatment Center at SUNY Downstate Medical Center, New York City. "Taking into consideration minorities and longer life expectancy, the real burden of diabetes is much greater than several people thought."

Banerji believes that "we need to act now. Immediate changes in diet, physical activity, stress and sleep are known to decrease diabetes and obesity. We can create changes in our physical environment to promote greater physical activity and we should consider changes in national food policy."

Diabetes remains the leading cause of new cases of blindness under age 75, kidney failure, and preventable leg and foot amputation among adults in the United States, according to the CDC.

In addition, people diagnosed with diabetes have health costs that are more than twice that of those without the disease, the agency reports. The total costs of diabetes in the United States are an estimated $174 billion annually, including $116 billion in direct medical costs.

Low dose of aspirin could cut cancer, study finds

A low dose of aspirin may reduce colon cancer cases by a quarter and deaths by a third, a new study found.

But experts say aspirin's side effects of bleeding and stomach problems are too worrying for people who aren't at high risk of the disease to start taking the drug for that reason alone.

Previous studies have found a daily dose of at least 500 milligrams of aspirin could prevent colon cancer, but the adverse effects of such a high dose outweighed the benefits. Now, researchers say a low dose, equivalent to a baby or regular aspirin, also appears to work.

European researchers looked at the 20-year results of four trials with more than 14,000 people that were originally done to study aspirin's use in preventing strokes. They found people taking baby or regular aspirin pills daily for about six years reduced their colon cancer risk by 24 percent and that deaths from the disease dropped by 35 percent. That was compared to those who took a dummy pill or nothing. There seemed to be no advantage to taking more aspirin than a baby-sized dose.

The study's conclusion that even low doses of aspirin can reduce colon cancer suggests the drug is inching its way toward being used for cancer prevention, though people should not start taking aspirin daily without consulting their doctor.

The studies used European baby aspirin of 75 milligrams and regular aspirin, 300 milligrams. US. baby aspirin is 81 milligrams and regular aspirin, 325 milligrams.

Gene may protect against alcoholism

Some people possess genetic characteristics that give them a low stage of response to alcohol. That means they have relatively little reaction to booze and need a lot of drinks to begin feeling an effect. These people -- sometimes described as folks who can drink everyone else under the table -- are also more susceptible to developing alcohol addiction.

Now a gene that may influence the reverse response has been found. Researchers reported Tuesday that a variant of the gene CYP2E1 influences a person's response to alcohol. But this gene variant causes people to react with high sensitivity to alcohol. A drink or two leaves them feeling inebriated. About 10% to 20% of the population are thought to carry this gene variant. Other research shows people who react powerfully to alcohol are less likely to become alcoholics.

The study advances the understanding of why several people become addicted and others do not. But genes aren't the whole story, said the lead author of the study Dr. Kirk Wilhelmsen, a professor of genetics at the University of North Carolina, Chapel Hill. "Alcoholism is a very complex disease," he said in a news release, "and there are lots of complicated reasons why people drink. This may be just one of the reasons."

The CYP2E1 gene encodes an enzyme that can metabolize alcohol. Unlike other enzymes that metabolize alcohol that work in the liver, this gene works in the brain. The gene and others that influence alcohol metabolism, might be used in the future to give people, particularly young people who have not yet started to drink, an idea of their odds of developing alcohol problems.

Study: Fish Oil Supplements May Not Benefit Pregnant Moms or Babies

Pregnant women have a lot to worry about when it comes to keeping their bodies and their developing babies strong. Now researchers in Australia report that fish-oil supplements, a popular nutritional boost that many moms-to-be thought helped boost their feel and their little ones' brain development, doesn't do much for either.

In a study of more than 2,300 pregnant women at five Australian hospitals between 2005 and 2008, scientists found that those who took fish-oil supplements — mostly in the form of docosahexaenoic acid, or DHA, a breakdown product of the original fatty fish oil — had the equal rates of postpartum depression as those taking a placebo.

In addition, the children born to women taking DHA showed no significant improvements in cognitive development at 18 months compared with those born to women not taking the supplements.

The results contradict previous findings in population-based studies that asked women about their DHA consumption after giving birth; those studies showed that women who consumed higher levels of fish oil had a 6% to 7% reduction in depressive symptoms following delivery than those who ate less. But the current study's findings are considered more reliable, since the investigators randomly assigned women to take either DHA or placebo and then observed rates of postpartum depression and measured childhood development markers such as language and other cognitive skills.

The fact that the trial did not find any mood or cognitive benefits to the fish-oil supplements, however, doesn't mean that women should stop eating fish or stop taking fish-oil supplements. The authors did find one positive correlation, and that was between DHA use and a lower risk of preterm birth, before 34 weeks (doctors consider 39 weeks full term). "There is no strong evidence supporting the benefits of these supplements," says Dr. Emily Oken, a professor of population medicine at Harvard Medical School, who wrote an editorial accompanying the paper in the Journal of the American Medical Association. "But my personal advice as a physician and mother is I encourage people to try to eat fish lower in mercury and higher in DHA, such as salmon, trout, herring and anchovies. Eating one or two servings of these fish a week will get women their recommended intake of DHA of 200 mg per day."

Balancing the Risks: Skin Cancer Patients Are Deficient in Vitamin D

It's a health conundrum that doctors have been trying to resolve for several years now: most Americans are deficient in vitamin D, which can help to build bones and even protect against certain cancers and autoimmune diseases such as multiple sclerosis, but the most efficient source of D, the sun, can also trigger skin cancers.

That means that skin cancer patients might be at even greater risk of having insufficient amounts of vitamin D, since they are instructed by their doctors to avoid the sun's cancer-causing ultraviolet rays. A study led by Dr. Jean Tang at Stanford University found that, indeed, skin cancer patients may be three times more likely to be vitamin D deficient than the general population. And the results also raise interesting questions about whether such shortcomings may be responsible for their cancer, or are a consequence of it.

Tang and her colleagues studied 41 patients with a rare genetic form of skin cancer that predisposes people to develop many skin cancer lesions over their lifetime. Over the two-year study period, the scientists measured the blood levels of a common vitamin D metabolite in the volunteers every three to six months. Not surprisingly, in order to avoid recurrent growths, most of the subjects used sunscreen daily, and avoided extended periods of sun exposure. While the mean levels of the D byproduct for the American population is 27.5 ng/ml, these skin cancer patients averaged 24.5ng/ml. “Even though you say the general population is at high risk of vitamin D deficiency, these skin cancer patients are at even higher risk,” says Tang.

At the moment, experts don't have a target “healthy” range of vitamin D in the blood, but a government panel is expected to provide more guidance on such a threshold in November. Until then, doctors generally advise their patients to take at least 200 IU to 400 IU of vitamin D daily, in supplement form. As for spending more time in the sun, physicians can't advise patients on how much sun is safe. “There isn't an easy answer,” says Tang. “But the safest recommendation is that some amount of sun exposure, such as what you would get by exercising outside or walking to your car or walking to work, is always reasonable. But it would be foolish to say go out and get a lot of sunlight to boost your vitamin D levels because sunlight is still a risk factor for skin cancer.”

Allergan shares jump after Botox migraine approval

Its shares rose $3.00, or 4.3 percent, to $71.88 in morning trade. The U.S. Food and Drug Administration accepted the potentially lucrative new use for Botox, Allergan's flagship product, late on Friday.

Allergan shares had risen in August when the company released information that indicated support of Botox for chronic migraine headaches use seemed near.

"Friday's approval of the chronic migraine indication for Botox will, we expect, prove to be a watershed in Allergan's revenue and earnings growth over the next some years," William Blair analyst Ben Andrew said in a research note.

Botox injections would be given around the head and neck every 12 weeks in an attempt to dull future migraines. Chronic migraine sufferers have headaches most days of the month. The drug has not been shown to work for people who have headaches 14 days or fewer per month.

Botox, with current annual sales of $1.4 billion, could eventually capture $600 million or more in additional annual sales from the migraine indication, according to analysts.

The product, which is injected and blocks nerve signals, is also being studied as a treatment for overactive bladder.

Botox is by far the world's biggest anti-wrinkle treatment. Allergan also has a dominant position with many of its other prescription drugs and medical devices.

It has more than 50 percent of the global market for breast implants, and its Juvederm is the leading dermal filler, used to smooth facial wrinkles. Allergan's Lap-Band, used in weight- loss procedures, commands two-thirds of the $300 million to $400 million gastric band market.

Moreover, Allergan has the industry's fastest-growing array of prescription eye medicines.

The company's leadership position in so many therapeutic areas has made it a darling of Wall Street, even though U.S. regulators have called Allergan to account for marketing Botox for unapproved non-cosmetic uses in recent years.

Q & A: Flu season tips

Question: Getting the flu is just so miserable. Am I at a higher risk of getting the flu this fall because I’m getting older?

Answer: I think we can all agree that the flu is awful! Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with the flu and have respiratory symptoms without a fever.

People who are over the age of 65 are at a higher risk of developing complications resulting from the flu than younger, healthy adults. Our human immune defenses become weaker with age, so influenza can be a very serious disease for people 65 and older.

There are actions you can take to prevent the flu. Here are the recommended preventative measures outlined by the Center for Disease Control and Prevention (CDC):

Get Your Flu Shot
The best way to prevent the flu is with a flu vaccine. CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine as soon as it becomes available in your community. Vaccination is especially important for people 65 years and older because they are at increased risk for complications from flu.

This season’s vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the 2009 H1N1 virus that caused so much illness last season. You should get vaccinated this year even if you got a 2009 H1N1 or a seasonal vaccine last year because the vaccine viruses have been updated. Immunity sets in about two weeks after vaccination, and the flu vaccine provides protection that lasts throughout the entire flu season.

This season, people 65 years and older will have two flu shots available to choose from—a regular dose flu vaccine and a new flu vaccine designed specifically for people 65 and older with a higher dose. This should result in a stronger immune response. Both vaccines will protect against the same three viruses. Talk to your doctor or nurse about the best option for you.

Take Everyday Preventive Actions
There are preventative actions you can take very day to prevent getting the flu. This includes covering you mouth when you cough, washing your hands often, and avoiding others who are sick.

Seek Medical Advice Quickly if you Develop Symptoms
If you suspect you may have the flu, it’s best to get checked out right away to see whether you need medical evaluation or treatment with antiviral drugs. It’s very important that antiviral drugs be used early to treat flu in people who are very sick with flu, like people who are in the hospital, and people who are sick with flu and have a greater chance of getting serious flu complications, like people 65 and older.
The CDC has a wealth of resources available that will help you learn more about the flu, symptoms, preventative measures, vaccines, treatments, and more. Visit their web site at http://www.cdc.gov/flu/.

Bone drugs get new fracture-risk warning

The FDA's review of bone-drug safety turned up enough evidence for a new warning about the risk of a rare-but-serious fracture of the thigh bone. There's been talk about a link between fractures and the popular class of osteoporosis drugs, known as bisphosphonates, for some time. But this is the first time FDA has required a new warning for the drugs' labels.

The warning will be added to those bone drugs approved for osteoporosis, whether oral--such as Merck's Fosamax, Roche and GlaxoSmithKline's Boniva, and Warner Chilcott's Actonel and new drug Atelvia (a next-generation version of Actonel)--or injectable, such as Novartis' Reclast. It won't apply to bisphosphonates marketed for cancer patients or Paget's disease, such as Novartis' Zometa.

FDA is asking doctors to keep a close eye on patients who've used bisphosphonates for longer than five years, because the fracture risk appears to be related to long-term use. The agency is continuing its safety review of long-term use of the drugs; so far, a causal link between the drugs and fractures hasn't been proven. Meanwhile, European regulators recently launched their own probe of the drugs and their possible link to stress fractures.

Reuters notes that the FDA warning could inspire patients to switch to Amgen's new bone drug, Prolia, which isn't a bisphosphonate. One analyst notes that Prolia sales could get a bump as early as next quarter. "Today's label change is likely to raise the level of concern among patients about the safety of bisphosphonates significantly," Bernstein & Co.'s Geoffrey Porges says in a research note.

Hundreds of Oakland nurses strike against health care cuts

Nurses in multi-colored scrubs lined the streets in front of Children's Hospital Oakland Tuesday, striking against what they say is a proposed cut in their health care benefits. Passing cars, BART trains and fire engines honked in support of the hospital's nearly 800 registered nurses as they began a three-day strike led by the California Nurses Association (CNA). The hospital will continue operating with over 100 replacement nurses until the strike is scheduled to end Friday morning.

Negotiators for the hospital and nurses' union have been unable to agree on a new contract since May 19, and have been operating with a temporary contract since July. Both sides signed off on a one-year wage freeze, but talks broke down in September when hospital representatives insisted on restructuring health care options to include an employee contribution of 15 percent toward their health care plan. According to Nato Green, spokesperson for the nurses' union, that would be one of the highest employee contribution rates of any Bay Area hospital.

Under the latest health care plan proposed by the hospital, nurses would pay up to $311 per month in premiums for a Preferred Provider Organization (PPO) plan. Around 60 percent of the hospital's nurses currently pay no premiums for the same PPO plan. The hospital would also offer two employer-paid health care options, but each either provides a lower level of coverage or would require employees to change providers. The CNA announced the strike on October 1.

Embryonic stem cells tested on patient for first time

Researchers in the U.S. have begun the world's first clinical trial of a new therapy for patients with spinal cord injuries, using human embryonic stem cells.

The groundbreaking experiment, run by a private biotechnology firm called Geron Corp., is still in an early phase, meant primarily to test the treatment for safety. But it could mark a landmark for a therapy that could have the potential to treat a variety of diseases.

The unidentified patient with a crushed spinal cord in being treated at Shepherd Center, a spinal cord and brain injury center in Atlanta, Ga., Geron Corp. said.

The patient is being treated with GRNOPC1, a trademark therapy that contains cells called oligodendrocyte progenitor cells. The cells turn into oligodendrocytes, which are cells that produce myelin, a nerve coating that allows impulses to move along the nerves.

The hope is that if the therapy works, the progenitor cells will produce new oligodendrocytes in the injured area of the patient's spine, potentially allowing for new movement.

Earlier studies on lab rats showed that GRNOPC1 significantly improved movement in animals with spinal cord injuries when injected seven days after the injury.

The company has said it plans to enroll eight to 10 patients in the study at sites across the U.S. All of the patients enrolled in the study will try the treatment within two weeks of their spinal cord injury. The therapy will be injected into the patients' spines between their third and 10th thoracic vertebrae, or roughly the middle to upper back.

This trial phase will take about two years, with each patient being studied for one year. If the therapy is shown to be safe in humans, that could then lead to larger and longer studies that would be more focused on the effectiveness of the therapy.

Later trials might also include patients with less severe spinal injuries and damage to other parts of the spine.

"Initiating the GRNOPC1 clinical trial is a milestone for the field of human embryonic stem cell-based therapies," Dr. Thomas B. Okarma, Geron's president and chief executive officer, said in a statement.

Hair straightening agents could be cancerous health hazards

A public alert has been issued over concerns raised by Portland-area hair salons about a product used for hair straightening, which could have negative health impacts.

Oregon Health and Science University's Centre for Research on Occupational and Environmental Toxicology (CROET) has issued two public alerts describing its findings on the health impacts that Brazilian Blowout, a hair-straightening agent, could cause.

Tests revealed that the product contained amounts of formaldehyde considered 'unsafe'. If a product used in a workplace contains more than 0.1 percent formaldehyde, OSHA requires the manufacturer to list it and address safe work practices on the material safety data sheet accompanying the product.

The formaldehyde standard includes requirements for employers to ensure that no employee is exposed to an airborne concentration of formaldehyde that exceeds 0.75 parts formaldehyde per millionin an eight-hour period.

"According to the Centers for Disease Control and Prevention, formaldehyde can produce a variety of effects, including immediate irritation of eyes, skin, nose and upper respiratory tract, cough, chest pain, shortness of breath and wheezing," explained Dede Montgomery, an occupational safety and health specialist and certified industrial hygienist at CROET.

"The major concerns of repeated formaldehyde exposure are sensitization, which is similar to an allergic condition, and asthma in those who have been previously sensitized to formaldehyde. Additionally, the Department of Health and Human Services has determined that formaldehyde may reasonably be anticipated to be a carcinogen," said Montgomery.

Health Insurance for Children

In today’s Patient Money column, Lesley Alderman writes about the various ways parents can find health coverage for their children, even if they think they can’t afford it.

Children in families with incomes of up to $44,100 (for a family of four) are likely to be eligible for some kind of government health insurance. In states where the cost of living is high, the income limits are even greater. In New York State, the cutoff for a family of four is $88,200; in New Jersey, it is $77,175.

The news is good for children, but it could be better. Almost 10 percent of children, or seven million of them, still do not have insurance. According to a recent report published in the journal Health Affairs, 4.7 million of those uninsured children are eligible for government coverage.

UPDATE: Calif. Sees Most Whooping Cough Cases Since 1955

More than 5,270 cases of whooping cough have been reported in California's growing epidemic, which has killed nine infants this year.

This week's report from the California Department of Public Health found that the highly contagious illness hasn't infected this many in the state since 1955, when 4,949 cases were reported for the entire year.

Whooping cough is a cyclical illness that peaks in the number of infections every five years.

Symptoms are similar to the common cold, making it a challenge to diagnose. A persistent cough that lasts weeks is the tell-tale symptom of the illness, which is also known as pertussis.

The bacterial infection tends to peak during summer months, but reporting lags make it difficult to determine if the peak has passed.

Typically, babies are given a series of vaccinations, then receive booster shots between ages 4 and 6 and again after age 10.

All of the whooping cough-related deaths in California occurred in babies too young to be fully immunized against the illness, which is why state health officials urge parents and caretakers get booster shots. Immunity wanes for the pertussis vaccine, so boosters are recommended every 10 years for adults.

Green Street: Commercial Property Values Up 30% Over 2009

It wasn’t more than two years ago that commercial real estate began a brutal downhill slide with no apparent end in sight, as investors and developers braced for an avalanche of mortgage defaults and foreclosures.

But, in another sign the dog days maybe coming to an end, property values have risen nearly 30% since the industry lows in 2009, according to an index by Green Street Advisors, a firm based in Newport Beach, Calif., specializing in research of real estate investment trusts.

According to the Green Street Advisors Commercial Property Price Index, almost half of the decline that occurred from the brutal industry downturn between 2007 and 2009 has evaporated, but values remain roughly 20% shy of their peak. Meanwhile, the index, comprised of $300 billion worth of commercial properties and assets owned by 53 REITs, rose 3% in September.

Expectations that commercial property values are on the mend and will see a robust recovery next year have fueled sharp gains in real estate stocks that have consistently beat the broader stock indexes like the Dow Jones Industrial Average and S&P 500 since last year.

“The rebound in pricing that began in earnest about a year ago has been impressive in terms of both its vigor and durability. Sellers are feeling less pressure to act, the outlook for fundamentals has improved, well-capitalized buyers are plentiful, and financing markets are recovering,” said Mike Kirby, Green Street’s Director of Research.

A big victory for people who need mental health care

Two federal laws that provide better insurance coverage for more people with mental health and substance abuse conditions are just beginning to take effect, and advocates describe the changes as a huge win for consumers that will greatly improve treatment.

As anyone who has ever sought help for addiction, depression or any other mental illness knows, insurance coverage is often skimpier than for a physical malady. Plans typically limit the number of therapy visits they'll pay for, and they may also impose separate deductibles for mental health and substance abuse services and require higher out-of-pocket contributions from patients as well.

Under the Mental Health Parity and Addiction Equity Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments. The law does away with different co-payments, deductibles and visit restrictions.

"These financial equalizers will be very helpful to families that have not been able to access care before," says Katherine Nordal, executive director for professional practice at the American Psychological Association.