Social anxiety disorder and its associated factors among adolescents of higher secondary schools of Birendranagar Municipality in Surkhet District: A cross-sectional study in Nepal

Social anxiety disorder (SAD), marked by a fear of negative judgment in social settings, is the most common mental health issue among adolescents. It often leads to avoidance, low self-esteem, social isolation, and serious risks like substance abuse and suicide. Despite its prevalence, the investigation of influencing factors towards SAD among adolescents in Nepal is limited. This study aimed to assess the prevalence of SAD and its associated factors among adolescents of higher secondary schools in Birendranagar Municipality of Surkhet district, Nepal. A cross-sectional study was conducted among 428 adolescents from higher secondary government and private schools. A multistage random sampling technique was employed to recruit the participants. A self-administered tool was used to collect the data. Univariate analysis was presented using numbers, percentages, means, and standard deviations. ANOVA and t-tests were performed to examine the association between SAD and independent variables. The Pearson correlation coefficient was determined to investigate the correlation between SAD with loneliness, self-esteem, and social media addiction, respectively. All the tests were conducted at a 95% confidence interval and variables with P-values less than <.05 were considered statistically significant. The mean (±SD) age of the participants was 16.9 ± 1.0 years. Most participants were male (52.8%) and attended government schools (63.6%). Mild social phobia was found in 28.8% of participants, while 22.4% had moderate social phobia. Grade 12 students exhibited significantly higher social phobia scores (24.8 ± 12.0, P < .05) compared to Grade 11. In addition, students from family's dependent on agriculture for income had higher social phobia scores (27.41 ± 11.39). This study demonstrated a positive correlation between SAD with loneliness (R = 0.233) and social media addiction (R = 0.168). Meanwhile, a negative correlation was found between SAD and self-esteem (r = -0.179). This study found a high prevalence of SAD among adolescents, which is influenced by education, lower-income level, loneliness, self-esteem, and social media addiction. These results underscore the importance of early detection of SAD and the need for school-based interventions such as skills training, parental support, peer engagement, and mental health awareness among adolescents having low self-esteem, social media addiction, and belonging to lower-income families. Establishing comprehensive support systems is essential to improving adolescents' mental well-being and reducing the impact of social anxiety.