Distribution of social anxiety symptoms and associated factors among undergraduate medical students in Mogadishu, Somalia: a cross-sectional study

BACKGROUND: Social anxiety is a common and debilitating psychiatric condition marked by an intense fear of negative evaluation in social situations, leading to significant impairments in occupational, academic, and daily functioning. Among medical students, this fear can significantly impede essential interpersonal interactions and academic performance. Despite its clinical significance, social anxiety remains under-researched in low-resource contexts, including Somalia. This study aims to assess the distribution and severity of social anxiety symptoms and identify its associated factors among medical students in Mogadishu, thereby informing targeted mental health interventions. METHODS: A cross-sectional study was conducted between April and May 2025 among 290 undergraduate medical students from six private universities in Mogadishu, Somalia. Data were electronically collected using a structured questionnaire and validated instruments, including the Social Phobia Inventory (SPIN), the Patient Health Questionnaire-9 (PHQ-9), the Oslo Social Support Scale-3 (OSSS-3), and the Rosenberg Self-Esteem Scale (RSES-10). Logistic regression analysis identified independent factors associated with social anxiety, sex differences were assessed via the Mann–Whitney U test, and associations with psychosocial variables were analyzed using Spearman’s rank-order correlation. Statistical significance was set at a p-value < 0.05. RESULTS: Of the 290 participants, 35.5% (95% CI: 30.0–41.3) met the criteria for social anxiety. Female students (AOR = 1.79; 95% CI: 1.03–3.14) and those who reported physical inactivity (AOR = 2.33; 95% CI: 1.17–4.61) had significantly higher odds of social anxiety. Psychosocial factors significantly associated with social anxiety included low self-esteem (AOR = 2.87; 95% CI: 1.19–6.95), depressive symptoms (AOR = 5.61; 95% CI: 2.91–10.82), poor social support (AOR = 2.33; 95% CI: 1.15–4.73), and parental criticism (AOR = 2.22; 95% CI: 1.20–4.13). CONCLUSION: This study demonstrates a high level of social anxiety among medical students in Mogadishu, Somalia, and identifies significant associations with demographic, behavioral, and psychosocial factors. The results underscore the importance of enhancing mental health awareness and psychoeducation within medical schools, alongside supportive and preventive approaches that address modifiable factors such as physical inactivity, low self-esteem, depressive symptoms, and limited social support. Strengthening general mental health literacy and supportive environments may contribute positively to students’ well-being and academic experiences and support the long-term resilience of the future medical workforce.