Nationally representative epidemiological study of social anxiety disorder from India

Satish Suhas; Pavithra Jayasankar; Rahul Patley; Narayana Manjunatha; Girish N Rao; Gopalkrishna Gururaj; Mathew Varghese; Vivek Benegal; NMHS National Collaborators group

doi:10.4103/indianjpsychiatry.indianjpsychiatry_826_23

Nationally representative epidemiological study of social anxiety disorder from India

Indian J Psychiatry. 2023 Dec;65(12):1261-1268. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_826_23. Epub 2023 Dec 11.

Authors

Satish Suhas¹, Pavithra Jayasankar¹, Rahul Patley¹, Narayana Manjunatha¹, Girish N Rao², Gopalkrishna Gururaj³, Mathew Varghese¹, Vivek Benegal⁴; NMHS National Collaborators group

Affiliations

¹ Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
² Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
³ Department of Epidemiology, Centre for Public Health, WHO Collaborative Centre for Injury Prevention and Safety Promotion, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
⁴ Department of Psychiatry, Centre for Addiciton Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

PMID: 38298869
PMCID: PMC10826865
DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_826_23

Abstract

Background: Social anxiety disorder (SAD), also termed as social phobia, is a disabling psychiatric condition with limited epidemiological research on it in India. This study, using data from the National Mental Health Survey (NMHS), 2016, is the first to explore its current prevalence and associated factors in India.

Materials and methods: The NMHS in India used a comprehensive population-based study with subjects selected through a multistage stratified random cluster sampling technique across 12 states. The study included 34,802 adults interviewed with the Mini-International Psychiatric Interview 6.0.0. Firth penalized logistic regression (FPLR) was used to estimate covariate odds ratios (ORs), and the treatment gap for SAD and disability measured using Sheehan's disability scale was calculated.

Results: The study found a 0.47% prevalence of SAD, with an average age of 35.68 years (standard deviation (SD) = 15.23) among those affected. Factors, such as male gender, unemployment, and living in urban areas, were associated with higher odds of SAD, while the elderly had lower odds. A significant proportion of individuals with SAD experienced disability in work (63%), social life (77%), and family life (68%). They spent a median of ₹ 2500 per month on treatment and had a high rate of comorbid psychiatric disorders (58%). The treatment gap was substantial at 82%.

Conclusions: A considerable portion of India's population (approximately >65 lakhs) is affected by SAD. Surprisingly, the NMHS 2016 report indicates a higher risk of SAD among males compared with females, a trend that warrants further investigation. SAD in India is linked to significant disability and a considerable treatment gap, emphasizing the need for innovative approaches to address this large, affected population, especially in light of the scarcity of mental health professionals.

Keywords: Disability; India; National Mental Health Survey; epidemiology; prevalence; social anxiety disorder; social phobia; treatment gap.