In February 2003, Hong Kong was hit by a community-wide outbreak of severe acute respiratory syndrome (SARS). During the period of the outbreak, 10 patients with SARS with psychiatric complications were referred to our Consultation and Liaison Psychiatry Team for assessment and management. We found that both the direct and indirect effects of SARS such as symptom severity, total isolation during treatment and administration of steroid were probable causes of psychiatric complications. In this paper, we report on the nature of their psychiatric problems, challenges to management and psychiatric treatment strategies used during the acute phase.