Archives of Sexual Behavior

, Volume 42, Issue 5, pp 863–872 | Cite as

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

  • Sandhya RamrakhaEmail author
  • Charlotte Paul
  • Melanie L. Bell
  • Nigel Dickson
  • Terrie E. Moffitt
  • Avshalom Caspi
Original Paper


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.


Sex partners Sexual behavior Anxiety Depression Substance use 



The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Health Research Council of New Zealand. This research also received support from the United Kingdom Medical Research Council (Grant G0100527) and from the National Institute of Mental Health (Grants MH45070 and MH49414). Terrie E. Moffitt and Avshalom Caspi are Royal Society Wolfson Research Merit Award holders. The authors are grateful to Richie Poulton, Director of the Research Unit, for valuable comments on earlier drafts of this paper. We thank Antony Ambler for assistance with the analyses. The authors are indebted to Phil Silva, the founder of the Dunedin Study, and to the Study members and their families for their long-term involvement.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sandhya Ramrakha
    • 1
    Email author
  • Charlotte Paul
    • 2
  • Melanie L. Bell
    • 2
    • 3
  • Nigel Dickson
    • 2
  • Terrie E. Moffitt
    • 4
    • 5
  • Avshalom Caspi
    • 4
    • 5
  1. 1.Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
  2. 2.Department of Preventive and Social Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
  3. 3.Psycho-Oncology Co-Operative Research Group, School of PsychologyUniversity of SydneySydneyAustralia
  4. 4.Departments of Psychology and Neuroscience and Psychiatry and Behavioral Sciences and Institute for Genome Sciences and PolicyDuke UniversityDurhamUSA
  5. 5.Social, Genetic, and Developmental Psychiatry Research Centre, Institute of PsychiatryKings CollegeLondonUK

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