Prevalence of anxiety among adolescent students of Ilam, Nepal

Background: Adolescence is a critical developmental stage marked by psychological, emotional, and social transitions, making individuals vulnerable to anxiety disorders. Neglecting adolescent mental health can have long-term repercussions. This study aimed to determine the prevalence of generalized anxiety disorder (GAD) and its associated factors among adolescent students of Ilam municipality, Nepal. Methods: A cross-sectional study was conducted among 416 adolescents aged 13–19 years, studying in grades 9–12 of public and private schools in Ilam district. Participants were recruited through random selection of schools and assessed using the Nepali-translated GAD-7 questionnaire. A GAD-7 score of >5 indicated anxiety, which was further categorized as mild (5–9), moderate (10–14), or severe (15–21). The association between anxiety and demographic or behavioral factors was assessed by chi-square. Results: The mean age of participants was 16.3 ± 1.6 years; 49.5% were male and 50.5% female. Overall, 56.5% exhibited symptoms of anxiety – 40.9% mild, 15.4% moderate, and 8.4% severe. Anxiety prevalence was significantly higher among females ( P < 0.001), students from private schools ( P = 0.041), and those not participating in outdoor games ( P = 0.019). No significant associations were found with age, religion, ethnicity, parental occupation, or education. Conclusion: More than half of the adolescents in Ilam municipality experienced anxiety, with higher rates among females, private-school students, and those lacking outdoor activity. The findings underscore the need for early school-based mental health screening and promotion of outdoor engagement to mitigate adolescent anxiety in Nepal.