Abstract
Background The comorbidity of social anxiety disorder is very common in schizophrenia patients and affects almost all age groups. This social anxiety disorder negatively impacts the quality of life, medication adherence, and treatment outcomes of people with schizophrenia. It is not well recognized in clinical settings. Therefore, assessing social anxiety symptoms and its associated factors was significant to early intervention and management of schizophrenia patients in Ethiopia. Methods An institution-based cross-sectional study was conducted at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Data collectors randomly recruited 423 schizophrenic patients by using the systematic sampling technique. A face-to-face interviewer-administered questionnaire was used to collect data. The standardized Liebowitz Social Anxiety Scale (LSAS) was employed to assess individual social anxiety symptoms. We computed bivariate and multivariate binary logistic regressions to identify factors associated with social anxiety symptoms. Statistical significance was declared at p < 0.05. Results The prevalence of social anxiety symptoms was 36.2% (95% CI: 31.50, 40.80). Male sex (AOR = 2.03, 95% CI: 1.20, 3.44), age of onset of schizophrenia (AOR = 1.91, 95% CI:1.17, 3.12), positive symptoms (AOR = 0.75, 95% CI:0.67, 0.83), depression/anxiety symptoms (AOR = 1.29, 95% CI: 1.18, 1.41), number of hospitalizations (AOR = 2.80, 95% CI:1.32, 5.80), and suicidal ideation (AOR = 0.44, 95% CI: 0.26, 0.74) were factors significantly associated with social anxiety symptoms at p < 0.05. p < 0.05. Conclusion The prevalence of social anxiety symptoms among schizophrenia patients was found to be high. Timely treatment of positive and depression/anxiety symptoms and suicide risk assessments and interventions need to be done to manage the problems.
Highlights
Schizophrenia is a severe and disabling chronic mental disorder characterized by deficits in the thought process, perception, and emotional responsiveness [1]
Social anxiety symptoms were measured using the Liebowitz Social Anxiety Scale Self-Reporting (LSAS-SR) questionnaire with cut-off points of 30 as it provided the best balance of sensitivity and specificity
The multivariate analysis suggested that age of onset of schizophrenia before 25 years had a 1.93 times greater likelihood of developing social anxiety symptoms compared to their counterparts
Summary
The comorbidity of social anxiety disorder is very common in schizophrenia patients and affects almost all age groups. This social anxiety disorder negatively impacts the quality of life, medication adherence, and treatment outcomes of people with schizophrenia. It is not well recognized in clinical settings. Assessing social anxiety symptoms and its associated factors was significant to early intervention and management of schizophrenia patients in Ethiopia. The prevalence of social anxiety symptoms among schizophrenia patients was found to be high. Treatment of positive and depression/anxiety symptoms and suicide risk assessments and interventions need to be done to manage the problems
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