title: Elderly suicide and the 2003 SARS epidemic in Hong Kong.
abstract: BACKGROUND
  Hong Kong was struck by the community outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003. In the same year, the elderly suicide rate in Hong Kong showed a sharp upturn from a previous downward trend.
  
  
  METHODS
  Secondary analyses using Poisson Regression Models on the suicide statistics from the Census and Statistics Department of the Hong Kong Government were performed.
  
  
  RESULTS
  In a Poisson Regression Model on the annual suicide rates in elders aged 65 and over in years 1986-2003, 2002 served as the reference year. Suicide rates in 1986-1997 were significantly higher than the reference year, with an Incident Rate Ratio (IRR) of 1.34 to 1.61. However, rates in 1998-2001 did not differ from the reference year significantly, representing stabilization of suicide rates for 4 years after 1997. The elderly suicide rate increased to 37.46/100,000 in 2003, with an IRR of 1.32 (p=0.0019) relative to 2002. Such trend is preserved when female elderly suicide rates in 1993-2003 were analyzed, while suicide rates in elderly men and younger age groups did not follow this pattern.
  
  
  CONCLUSIONS
  Mechanistic factors such as breakdown of social network and limited access to health care might account for the findings. These factors could have potentiated biopsychosocial risk factors for suicide at individual levels, particularly in elderly. Female elders, by way of their previous readiness to utilize social and health services instituted in the past decade, are thus more susceptible to the effects of temporary suspension of these services during the SARS epidemic.
  
  
  CONCLUSIONS
  The SARS epidemic was associated with increased risk of completed suicide in female elders, but not in male elders or the population under 65 years of age.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong. schan@cuhk.edu.hk
authors.forename: Sau Man Sandra
authors.initials: SM
authors.lastname: Chan
authors.forename: Fung Kum Helen
authors.initials: FK
authors.lastname: Chiu
authors.forename: Chiu Wah Linda
authors.initials: CW
authors.lastname: Lam
authors.forename: Pui Yiu Vivian
authors.initials: PY
authors.lastname: Leung
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D000367:Age Factors; D000368:Aged; D019352:Censuses; D004196:Disease Outbreaks; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology*; D017678:Sex Distribution; D013405:Suicide / Q000639:trends*