Prevalence of Depression and Anxiety Among Nigerian Adolescents and the Impact of School-Based Cognitive Behavioural Therapy: A Randomized Controlled Trial
Abstract:
Mental health
disorders, including depression and anxiety, pose a significant challenge among
adolescents in low- and middle-income countries [LMICs] like Nigeria, where
access to mental health care is limited. This study evaluated the prevalence of
these conditions and the efficacy of school-based Cognitive Behavioural Therapy
[CBT] among Nigerian adolescents through a randomized controlled trial [RCT].
239 adolescents between the ages of 12 and 18 from secondary schools in
Abeokuta, Ogun State, were randomly divided into two groups: 120 students
participated in a CBT intervention group, while the remaining 119 formed a
control group. The CBT programme, delivered by trained school counsellors over
three weeks [three 45-minute sessions per week], focused on cognitive
restructuring and coping strategies. Pre- and post-intervention assessments
used the Patient Health Questionnaire-9 [PHQ-9] and Generalised Anxiety
Disorder-7 [GAD-7] scales. Statistical analysis employed repeated measures
ANOVA with significance set at p < 0.05. Baseline prevalence indicated 46.3%
mild and 26.0% moderate depression, and 38.0% mild and 42.4% moderate anxiety.
Post-intervention, the CBT group showed a significant reduction in anxiety [p =
0.001, Cohen’s d = 3.586] and a borderline significant reduction in depression
[p = 0.059, Cohen’s d = 3.856] compared to the control group. Additional
benefits included improved emotional regulation [p = 0.02, Cohen’s d = 0.61]
and coping strategies [p = 0.01, Cohen’s d = 0.69], with no significant changes
in the control group. In conclusion, School-based CBT is an effective and
feasible intervention for reducing anxiety and depression among Nigerian
adolescents, with potential for scalability in similar settings. Future studies
should explore extended interventions and longitudinal outcomes to optimise
impact.
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