Social media use and anxiety levels among school adolescents: a cross-sectional study in Kathmandu, Nepal.

Introduction: Excessive social media (SM) usage is the foremost factor contributing to anxiety. While these platforms facilitate connection and entertainment, their overuse can negatively impact adolescents' mental well-being. The study aimed to evaluate both SM usage and levels of anxiety while assessing potential associations between the two. Methods: A cross-sectional descriptive study was conducted among 401 school-age adolescents (14-17 years) in grades 9 and 10 through self-administered questionnaires. Kruskal-Wallis test was used as a non-parametric test to compare the groups, and ordinal logistic regression was used to model the relationship between ordinal dependent and independent variables. Results: The study reported high SM usage (43.6% spent 4-8 hours daily). Females and grade 9 students were more prone to severe anxiety (45.2% and 34.3%, respectively). Despite privacy concerns (93.3%), 37.9% shared their accounts. Severe anxiety was prevalent (35.4%), with males exhibiting less odds of severe anxiety compared with females (OR=0.37, p value <0.001) and higher usage frequency and duration associated with increased anxiety (p<0.001 in the Kruskal-Wallis test). Those dependent on SM had 1.15 times higher odds of severe anxiety, while those not taking breaks showed lesser anxiety (OR=0.89, β=-0.10). Conclusions: Involvement of adolescents in SM is associated with their anxiety levels, with factors like gender, usage patterns, and behaviours on these platforms playing important roles. This emphasises the need to understand how SM affects mental well-being and highlights the impact of their usage behaviours and concerns about privacy.