Prevalence and Correlates of Mental Health Disorders in School-Going Adolescents in Enugu State, South East Nigeria: A School-Based Survey

Adolescent mental health disorders are a major yet under-recognised public health burden in Nigeria, where mental health services are scarce and stigma remains high. This school-based cross-sectional study estimates the prevalence and correlates of mental health disorders among adolescents aged 12 to 19 years in public secondary schools in Enugu State, South East Nigeria. A stratified random sample of 1,240 students from 16 schools across four local government areas participated. The Strengths and Difficulties Questionnaire (SDQ) and General Health Questionnaire-12 (GHQ-12) were administered. Clinical validation of screen-positive cases was conducted using DSM-5 criteria via structured psychiatric interviews. Screen-positive prevalence was 31.4% using SDQ. Clinically confirmed psychiatric disorders were identified in 21.8% of adolescents, with depressive disorders (9.6%), anxiety disorders (7.2%), and conduct disorders (4.3%) being most prevalent. Significant risk factors included exposure to domestic violence, bullying victimisation, academic pressure, and single-parent household structure. Female students demonstrated higher rates of internalising disorders, while males had higher rates of externalising disorders. Social support from teachers was a significant protective factor. Only 6.4% of screen-positive adolescents had previously sought mental health support. The study provides the first large-scale school-based mental health prevalence data from Enugu State and recommends school-based mental health programmes, trained counsellors in schools, and adolescent-friendly health service expansion. Keywords: adolescent mental health, prevalence, SDQ, Enugu State, South East Nigeria.