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evere acute respiratory syndrome (SARS) is caused by a novel and highly transmissible coronavirus (1). It spread rapidly to 30 countries via air travel (2). Probable SARS cases (n = 8422) resulted in 916 deaths, or a mortality rate of 11%; one-quarter of all cases occurred in Hong Kong (3). Early SARS is clinically similar to influenza (4), so a terror-stricken public stayed home to avoid cross infection. Worldwide, health care workers (HCWs) accounted for up to 50 % of Can J Psychiatry, Vol 49, No 6, June 2004 385 Objective: To examine stress and psychological impact in severe acute respiratory syndrome (SARS) patients during the 2003 outbreak. SARS is a novel, highly infectious pneumonia, and its psychological impact is still unclear. Method: At the peak of the outbreak, SARS patients (n = 79) and healthy control subjects (n = 145) completed the Perceived Stress Scale (PSS) and documented a range of psychological responses. Groups were balanced for age, sex, education, and living circumstances. Results: Stress was significantly higher in SARS patients than in healthy control subjects. Stress correlated significantly with negative psychological effects. Of SARS patients, 39% (n = 30) were infected health care workers; these individuals reported significantly more fatigue and worries about health than did other patients. Of patients, 25 % (n = 20) requested psychological follow-up. Conclusions: General stress and negative psychological effects are increased in SARS patients, particularly among infected health care workers. This may increase the risk of mood and stress-related disorders. Functional impairment is apparent in the postrecovery phase. (Can J Psychiatry 2004;49:385–390) Information on author affiliations appears at the end of the article