Parental substance use and adolescent psychiatric symptom profiles in Lagos, Nigeria: school-based cross-sectional study

BACKGROUND: Parental substance use (PSU) is associated with increased psychiatric risk among offspring, but evidence from Sub-Saharan Africa remains limited. AIMS: To examine cross-sectional associations between PSU and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) algorithm-defined adolescent psychiatric symptom profiles in Lagos, Nigeria, and assess whether family dysfunction statistically attenuates these associations. METHOD: Data came from the Lagos Schools Emotional and Behavioural Health Survey, a school-based sample of 9437 adolescents aged 11-17 years. PSU was categorised as neither parent, only father, only mother or both parents using substances, defined as adolescent-reported at least weekly parental alcohol consumption or tobacco use over the past 12 months. Psychiatric symptom profiles were identified using structured MINI-KID self-report algorithms administered with trained research-assistant support. Logistic regression estimated adjusted odds ratios (aORs). Family dysfunction, defined as domestic violence or high family conflict, was examined using cross-sectional statistical attenuation models. RESULTS: PSU was reported by 20.0% of adolescents: 17.3% father-only, 1.3% mother-only and 1.4% both parents. Associations followed a graded pattern. Dual-parent PSU was associated with increased odds of symptoms meeting algorithm thresholds for substance use disorder (aOR = 5.84, 95% CI 3.42-9.97), alcohol use disorder (aOR = 4.98, 95% CI 3.09-8.03) and major depressive disorder (aOR = 2.81, 95% CI 1.94-4.07). Family dysfunction partially attenuated selected associations. CONCLUSIONS: PSU was associated with elevated adolescent psychiatric symptom profiles in a graded fashion. Findings are cross-sectional and do not establish causality. Outcomes represent self-reported symptoms meeting MINI-KID algorithm thresholds, not clinician-confirmed diagnoses.