Epidemiology of Online Gambling Disorder among Adolescents in Southern Nigeria: A Comparative Analysis of Prevalence, Psychosocial Correlates, and Mental Health Implications

Purpose: The digital transformation of gambling in Sub-Saharan Africa poses a severe and under-researched threat to adolescent mental health. This study assessed the prevalence of Gambling Disorder (GD), its comorbid mental health conditions, and associated functional impairments among in-school adolescents in two major Nigerian regions. Methods: A comparative and school-based cross-sectional survey was conducted with 900 adolescents aged 13 to 17 from Lagos in the South-West and Enugu in the South-East. Participants were selected via stratified cluster sampling. Assessments included the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), the Internet Addiction Test (IAT), and the Patient Health Questionnaire-9 (PHQ-9). Complex sample analyses were used. Results: The prevalence of GD was alarmingly high at 31.1% in Lagos and 38.0% in Enugu. Online platforms were the primary mode of access. Adolescents with GD exhibited significantly higher rates of comorbid internet addiction (AOR = 3.5; 95% CI: 2.6–4.8) and depressive symptoms. Severe functional impairments included school absenteeism (21.0%) and gambling-related debt (42.7%). Conclusions: Adolescent GD in Southern Nigeria is a pervasive mental health crisis deeply intertwined with digital addiction and depression. Findings urgently call for integrating GD screening into adolescent mental health services and implementing school-based preventive interventions that address the digital syndemic.