title: The impact of epidemic outbreak: the case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong.
abstract: BACKGROUND
  Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003.
  
  
  OBJECTIVE
  In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong.
  
  
  METHODS
  We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly.
  
  
  RESULTS
  SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths.
  
  
  CONCLUSIONS
  We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community. In addition, it is important to alert family members to vulnerable individuals who are at potential risk because of their illnesses or anxieties.
authors.affiliation: HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong. sfpyip@hku.hk
authors.forename: Paul S F
authors.initials: PS
authors.lastname: Yip
authors.forename: Y T
authors.initials: YT
authors.lastname: Cheung
authors.forename: P H
authors.initials: PH
authors.lastname: Chau
authors.forename: Y W
authors.initials: YW
authors.lastname: Law
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005239:Fear; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D009042:Motivation; D045169:Severe Acute Respiratory Syndrome / Q000401:mortality* / Q000523:psychology*; D012934:Social Isolation; D013315:Stress, Psychological / Q000150:complications; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*