The Relationship Between Multiple Sex Partners and Anxiety, Depression, and Substance Dependence Disorders: A Cohort Study

Abstract

Changes in sexual behavior have resulted in longer periods of multiple serial or concurrent relationships. This study investigated the effects of multiple heterosexual partners on mental health, specifically, whether higher numbers of partners were linked to later anxiety, depression, and substance dependency. Data from the Dunedin Multidisciplinary Health and Development Study, a prospective, longitudinal study of a birth cohort born in 1972–1973 in Dunedin, New Zealand were used. The relationship between numbers of sex partners over three age periods (18–20, 21–25, and 26–32 years) and diagnoses of anxiety, depression, and substance dependence disorder at 21, 26, and 32 years were examined, using logistic regression. Interaction by gender was examined. Adjustment was made for prior mental health status. There was no significant association between number of sex partners and later anxiety and depression. Increasing numbers of sex partners were associated with increasing risk of substance dependence disorder at all three ages. The association was stronger for women and remained after adjusting for prior disorder. For women reporting 2.5 or more partners per year, compared to 0–1 partners, the adjusted odd ratios (and 95 % CIs) were 9.6 (4.4–20.9), 7.3 (2.5–21.3), and 17.5 (3.5–88.1) at 21, 26, and 32 years, respectively. Analyses using new cases of these disorders showed similar patterns. This study established a strong association between number of sex partners and later substance disorder, especially for women, which persisted beyond prior substance use and mental health problems more generally. The reasons for this association deserve investigation.

Binge Drinking in Young Adulthood: The Influence of Age at First Intercourse and Rate of Sex Partner Accumulation

“…Two longitudinal studies provide evidence that this is the case, showing that multiple sexual partners and more frequent sexual activity predicts young people’s risk for substance dependence disorder and their trajectories of heavy drinking, respectively (Ramrakha et al, 2013; Windle et al, 2005). One recent longitudinal study, however, suggests that alcohol use may precede rather than follow sexual behavior, such that adolescents with higher levels of alcohol use go on to accumulate a larger number of sexual partners as they transition to adulthood (Dogan et al, 2010).…”

“…To our knowledge, the effect of rate of sexual partner accumulation on health-risk behaviors has been investigated in just one other study: Using a sample young adults in New Zealand, Ramrakha and colleagues (2013) found that number of sex partners accrued per year increased the odds of being diagnosed with alcohol dependence disorder. The current study differs from this work in two key ways.…”

“…Ramrakha and colleagues’ work is based on a population outside of the United States, and therefore, their study may not be generalizable to the experiences of young individuals in this country. Second, our measure of partner accumulation measures the average number of sex partners each respondent accrued per year from sexual initiation onward, whereas the work by Ramrakha and colleagues (2013) measured the number of annual partners accrued within specific age periods (18–20, 21–25, and 26–32 years). Because adolescents who initiate intercourse prior to age 18 tend to accumulate more annual sex partners than those who delay the initiation of intercourse to later ages (Martinez et al, 2011), it is important to consider how individuals’ entire sexual history, from the onset of sexual initiation, influences subsequent binge drinking.…”

“…Many studies indicate that several dimensions of sexual activity, including age at sexual initiation and number of sexual partners, are linked with alcohol use (Cavazos-Rehg et al, 2011; Dogan, Stockdale, Widaman, & Conger, 2010; Guo et al, 2002; Howard & Wang, 2004; Makenzius & Larsson, 2012; Ogletree, Dinger, & Vesely, 2001; Ramrakha et al, 2013). Indeed research shows that early initiation of intercourse and more sexual partners is associated with binge drinking (Guo et al, 2002; Howard & Wang, 2004; Makenzius & Larsson, 2012; Ogletree et al, 2001).…”

The Swiss Cohort Study on Substance Use Risk Factors – Findings of two Waves

“…Examples are the Christchurch Health and Development Study (Goodwin, Fergusson, & Horwood, 2004) or the Dunedin Multidisciplinary Health and Development Study (Ramrakha et al, 2013) in New Zealand as well as a study of 44 schools in Victoria, Australia (Degenhardt et al, 2013). Surprisingly, however, there have been few general population cohort studies in Europe on the development of substance use between late adolescence and early adulthood.…”