Health advantage for black women: patterns in pre-menstrual dysphoric disorder.
BACKGROUND
Pre-menstrual dysphoric disorder (PMDD) is commonly studied in white women; consequently, it is unclear whether the prevalence of PMDD varies by race. Although a substantial proportion of black women report symptoms of PMDD, the Biocultural Model of Women's Health and research on other psychiatric disorders suggest that black women may be less likely than white women to experience PMDD in their lifetimes.


METHODS
Multivariate multinomial logistic regression modeling was used with a sample of 2590 English-speaking, pre-menopausal American women (aged 18-40 years) who participated in the Collaborative Psychiatric Epidemiology Surveys in 2001-2003. The sample consisted of 1672 black women and 918 white women. The measure of PMDD yields a provisional diagnosis of PMDD consistent with DSM-IV criteria.


RESULTS
Black women were significantly less likely than white women to experience PMDD [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.25-0.79] and pre-menstrual symptoms (OR 0.64, 95% CI 0.47-0.88) in their lifetimes, independently of marital status, employment status, educational attainment, smoking status, body mass index, history of oral contraceptive use, current age, income, history of past-month mood disorder, and a measure of social desirability. The prevalence of PMDD was 2.9% among black women and 4.4% among white women.


CONCLUSIONS
This study showed for the first time that black women were less likely than white women to experience PMDD and pre-menstrual symptoms, independently of relevant biological, social-contextual and psychological risk factors. This suggests that PMDD may be an exception to the usual direction of racial disparities in health. Further research is needed to determine the mechanisms that explain this health advantage.
Yale School of Medicine, Department of Psychiatry, New Haven, CT 06516, USA. corey.pilver@yale.edu
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D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011293:Premenstrual Syndrome / Q000453:epidemiology*; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American