The Department of Epidemiology is one of the top research epidemiology departments in the country. The department’s many areas of emphasis focus on the prevention and treatment of chronic disease and contribute to the improved understanding of cancers, diabetes, osteoporosis, and aging, as well as the relationship of lifestyle factors such as diet and exercise to genetic susceptibility. Our research programs extend a global reach to South America, Southeast Asia, and Africa.
Faculty members in each of these areas offer major research and/or community service programs that provide excellent facilities for student research and field training.
- Aging
- Applied public health
- Cancer
- Cardiovascular and diabetes
- Clinical trials and methods
- Global health
- Infectious disease
- Injury prevention
- Molecular and genetic
- Nutritional
- Population neuroscience
- Prevention, lifestyle, and physical activity
- Reproductive, perinatal, and pediatric
- Social epidemiology and health equity
- Women’s health
Aging Epidemiology
Faculty Contact: Elsa Strotmeyer, PhD, MPH
- Areas of research broadly include: musculoskeletal health, mobility, and disability; body composition and sarcopenia; osteoporosis and osteoarthritis; falls and fall injuries; biology of aging and longevity; physical activity, fitness, fatigability and healthy lifestyle; environmental and social factors; health services; diabetes and cardiovascular aging; cognitive and mental health; sleep and circadian science; and clinical geroscience.
- Training Grant: Epidemiology of Aging. All trainees participate in a four-course series on aging, hands-on research training, research conferences, and seminars. Additional career development opportunities for post-doctoral students are available.
- All doctoral trainees design, implement, analyze data, and report the results of an independent study as part of the program with a goal of submitting three manuscripts for publication. Trainees are encouraged to present their research in a variety of venues, including Public Health Dean's Day, Aging Institute Research Day, and national scientific meetings.
- Faculty members primarily working in this area include: Jane Cauley (Emeritus), Tamara Dubowitz, Sameneh Farsijani, Nancy Glynn, Megan Marron, Iva Miljkovic, Anne Newman (Emeritus), Caterina Rosano, Andrea Rosso, Akira Sekikawa, Elsa Strotmeyer, and Joseph Zmuda.
- Collaborating Faculty include: Steven Albert (Behavioral and Community Health), Jennifer Brach (Health and Rehabilitation Sciences), Maria Mori Brooks, Janet Catov (Obstretics, Gynecology & Reproductive Sciences), Daniel Buysse (Psychiatry), Julie Donohue (Health Policy and Management), Toren Finkel (Cardiology), Daniel Forman (Geriatrics), Tiffany Gary-Webb, Walid Gellad (Internal Medicine), Aditi Gurkar (Geriatrics), Steven Handler (Geriatrics), Marquis Hawkins (Psychology), Erin Kershaw (Endocrinology), Oscar Lopez (Neurology), Kathleen McTigue (Internal Medicine), Neelesh Nadkarni (Geriatrics), Brad Nindl (Sports Medicine and Nutrition), Patricia Opresko (Environmental and Occupational Health), Sara Piva (Health and Rehabilitation Sciences), Elizabeth Shaaban (Nursing), John Shaffer (Human Genetics), Stephen Smagula (Psychiatry), Sonja Swanson, Rebecca Thurston (Psychiatry), and Frederico Toledo (Endocrinology).
Applied Public Health Epidemiology
Faculty Contact: Catherine Haggerty, PhD, MPH
- Areas of focus include: population health status assessment; disease and injury surveillance; maternal and child health epidemiology; healthcare-acquired infection surveillance; infection prevention; and environmental health epidemiology.
- Opportunities include practicum experiences, independent study and other applied projects. An enhanced practicum experience is the Summer Institute in Applied Public Health at the Allegheny Health Department.
- Faculty members currently working in this area include Tiffany Gary-Webb, Catherine Haggerty, Marshal Ma, Dara Mendez, Thomas Songer, Alexander Sundermann, and Evelyn Talbott (Emeritus).
- Training and funding opportunities include: Equity in Maternal and Birth Outcomes and Reproductive Health through Community Engagement (EMBRACE) Center of Excellence and the Center of Excellence in Maternal and Child Health Education, Science, and Practice.
Cancer Epidemiology
Faculty Contacts: Jian-Min Yuan, MD, PhD
- Research focus areas include: aging and cancer; cancer molecular epidemiology; environmental exposures and gene-environment interaction in risk of cancer development; cancer screening and early detection; natural occurring compounds for primary prevention of cancer.
- An advanced course is offered in EPIDEM 2171 Cancer Epidemiology on topics of surveillance, etiology and prevention.
- Training Grant: Translational Research Training in Cancer Etiology and Prevention. The T32 training grant supports one pre-doctoral student and three postdoctoral fellows per year whose research focus is on cancer epidemiology, prevention, cancer risk biomarkers, cancer screening and early detection, and survivorship for patients after cancer diagnosis.
- Cancer Epidemiology and Prevention Program Seminar series at the UPMC Hillman Cancer, a National Cancer Institute-designated Comprehensive Cancer Center.
- Faculty members currently working in this area include: Tamara Dubowitz, Brenda Diergarde (Human Genetics), Robert Schoen (Medicine), Jian-Min Yuan, and Joseph Zmuda.
Cardiovascular & Diabetes Epidemiology
Faculty Contact: Akira Sekikawa, MD, MPH, PhD
Cardiovascular epidemiology research spans four major domains:
- Vascular structure and function: subclinical atherosclerosis, arterial stiffness, endothelial function, and vascular aging (see Ultrasound Research Laboratory).
- Population and life-course science: cardiovascular aging and longevity, women’s health, high-risk and international populations.
- Lifestyle and metabolic determinants: nutrition, environmental influences, lipid metabolism, body composition, obesity, sleep, and physical activity.
- Emerging and novel research directions: new cardiovascular risk factors, mechanistic pathways, omics, and evaluation of preventive and therapeutic interventions.
Diabetes areas of research include long-standing programs in both Type 1 and Type 2 diabetes with world-leading longitudinal cohorts and prevention research.
- Type 1 diabetes:
– The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study, a 40-year follow-up of childhood-onset Type 1 diabetes
– The landmark national DCCT/EDIC study, now with more than 40 years of continued follow-up - Type 2 diabetes:
– The Diabetes Prevention Program Outcomes Study (DPPOS), a major multicenter trial of lifestyle and pharmacologic prevention
– The Diabetes Prevention Support Center and its global translation initiative, Group Lifestyle Balance, which adapts DPP strategies for community-based implementation worldwide
Training Grant: Cardiovascular Disease Epidemiology Training Program. The program's philosophy is to provide a core foundation of didactic training in Cardiovascular Epidemiology with strong methodological and quantitative skills, customized to the experience and background of each trainee. The Training Program is organized around three research cores: 1) subclinical atherosclerosis, 2) biostatistics/epidemiological methods and 3) cardiology grounded in six areas of strength (i) vascular aging, (ii) women's health, (iii) high risk & international populations, (iv) nutrition & environment, (v) physical activity and (vi) psychosocial factors. To address novel opportunities in epidemiological research, our Program incorporates experiences for trainees in using Big Data, electronic health record, omics and mobile health for which we have rich faculty expertise.
Faculty members currently working in this area include: Timothy Anderson (Medicine), Marnie Bertolet, Lisa Bodnar, Maria Brooks, Janet Catov (Obstetrics, Gynecology & Reproductive Sciences), Jane Cauley (Emeritus), Tina Costacou, Tamara Dubowitz, Samaneh Farsijani, Linda Fried (Medicine), Tiffany Gary-Webb, Seyoung Kim, Ingred Libman (Children’s Hospital), Oscar Lopez (Neurology), Jared Magnani (Cardiology), Oscar Marroquin (Medicine), Iva Miljkovic, Rachel Miller, Suresh Mulukutla (Medicine), Anne Newman (Emeritus), Sanjay Patel (Medicine), Bonny Rockette-Wagner, Bruce Rollman (Medicine), Caterina Rosano, Akira Sekikawa, Thomas Songer, Sonja Swanson, Elsa Strotmeyer, Rebecca Thurston (Psychiatry), and Joseph Zmuda.
Clinical Trials & Methods
Faculty Contact: Marnie Bertolet, PhD and Sonja Swanson, ScD
- The activities of the Clinical Trials & Methods group contribute to all areas of emphasis, specializing in design and conduct of studies, including observational and interventional, and statistical methods.
- The didactic component includes 6 courses
EPIDEM 2110 - PRINCIPLES OF EPIDEMIOLOGY,
EPIDEM 2180 - FUNDAMENTALS OF EPIDEMIOLOGICAL METHODS,
EPIDEM 2181 - DESIGN AND CONDUCT OF CLINICAL TRIALS,
EPIDEM 2192: CAUSAL INFERENCE FOR EPIDEMIOLOGIC RESEARCH
EPIDEM 2193: MACHINE LEARNING METHODS
EPIDEM 2230 - SECONDARY DATA ANALYSIS: A CAPSTONE COURSE.
- The Epidemiology Data Center (EDC) was established in 1980 as a section of the Department of Epidemiology, founded and formerly directed by Katherine M. Detre, MD, DrPH, and now under the co-direction of Steven Bell, Maria Brooks, and Stephen Wisniewski. The EDC has collaborated in over 100 research studies and personnel currently contribute to, or coordinate, data management and analysis activities for research projects sponsored by federal and various other governmental or private agencies and by industry. For more information, see the EDC website.
- The EDC hosts the Clinical and Translational Science Institute (CTSI) Biostatistics, Epidemiology and Research Design (BERD) Core providing data management and analysis support and consultation to researchers. Services include: grant application development and the pairing of researchers with statistical collaborators. It also hosts a Journal Club.
- Faculty members in this Area of Emphasis include: GK Balasubramani, Steven Belle, Marnie Bertolet, Maria Mori Brooks, Alicia Colvin, Anthony Fabio, Samaneh Farsijani, Seyoung Kim, Megan Marron, James Matuk, Rachel Miller, Bedda Rosario, Kristine M. Ruppert, Robert Schoen (Medicine), Sonja Swanson, and Stephen Wisniewski.
Global Health Epidemiology
Faculty Contact: Jean Nachega, MD, PhD, MPH
- Areas of research Include: maternal and child health (rural India); hypertension, cardiovascular disease (rural India and Tobago); impaired kidney function (Tobago); infectious diseases/HIV/Tuberculosis/Mpox (Brazil, India, Mozambique, DR Congo, Nigeria, Cameroon, and South Africa); COVID-19 (Ghana, Nigeria, Democratic Republic of the Congo, Uganda, Kenya, South Africa, Rwanda, Mozambique); Sickle Cell Disease (Ghana); prostate cancer (Tobago and Nigeria); cancer (China); environmental health (China); application of the Internet and Mobile technology for global health and prevention; infectious diseases/dengue modeling (Thailand, Cambodia, Laos, Vietnam, Philippines, Singapore, Malaysia, Taiwan, Brazil, and Columbia); and atherosclerosis, coronary heart disease, Alzheimer's disease, and chronic obstructive pulmonary disease (Japan).
- Training Grants:
- Faculty members currently working in this area include: Catherine Haggerty, Lee Harrison (Medicine), Iva Miljkovic, Jean Nachega, Akira Sekikawa, Jian-Min Yuan, and Joseph Zmuda.
Infectious Disease Epidemiology
Faculty Contact: Lee Harrison, MD
- Areas of research include: epidemiology and genomic epidemiology of serious, vaccine-preventable, drug-resistant and hospital-associated bacterial infections; prevention of HIV infection; infectious diseases surveillance; computational modeling of disease and intervention strategies; hospital transmission of bacteria, SARS-CoV-2, and other respiratory viruses.
- Training Grants:
- All doctoral trainees conduct an independent study with the requirement to submit three manuscripts for publication. Trainees can choose traditional epidemiology or genomic epidemiology as the basis of their doctoral research.
- Faculty members include: Steven Belle, Catherine Haggerty, Lee Harrison (Medicine), Jean Nachega, Graham Snyder (Medicine) and Alexander Sundermann.
Injury Prevention Epidemiology
Faculty Contacts: Thomas Songer, PhD, MPH
- Applied research in broad areas of unintentional and intentional injury including but not limited to injury from motor vehicle crash, falls, poisoning, head trauma, violence, and treatment of injury.
- Emphasis on the application of epidemiologic methods in population and clinical settings to understand key risk and prognostic factors for primary and secondary prevention of injury.
- Trainees participate in academic training in injury epidemiology and applied research training on specific injury and violence topics using mentors from multiple disciplines in the fields of epidemiology, statistics, trauma, behavioral sciences, surgery, psychiatry, criminology, and others.
- Faculty members currently working in this area include: Steven Albert (Behavioral and Community Health Sciences), Thomas Songer, Sonja Swanson, and Stephen Wisniewski.
Molecular & Genetic Epidemiology
Faculty Contact: Joseph Zmuda, PhD
- Areas of current research include: aging, cancer, cardiovascular disease, diabetes, obesity, cognition and dementia, sarcopenia and physical function, infectious disease, osteoporosis, and reproduction and child development.
- This training program can be incorporated into any number of research outcomes and other AOEs. Students interested in Molecular Epidemiology often work on large epidemiologic cohorts with existing molecular data. However, there are also opportunities for students to generate their own molecular/genetic data and research projects. Both the Aging and Cardiovascular T32 Training Programs have incorporated trainees with interest in Molecular and Genetic Epidemiology into their programs.
- Course requirements vary depending on student background and needs, though the Molecular Epidemiology course (EPIDEM 2600 - INTRODUCTION TO MOLECULAR EPIDEMIOLOGY) is a required course for all Epidemiology PhD Students. Additional courses are often sought to align with students' specific research and dissertation plans including courses from the departments of Human Genetics, Biostatistics, Environmental and Occupational Health and/or Medicine, among others.
- All doctoral trainees conduct an independent study with the requirement to submit three manuscripts for publication.
- Primary Faculty members currently working in this area include: Catherine Haggerty, Iva Miljkovic, Rachel Miller, Caterina Rosano, Jian-Min Yuan, and Joseph Zmuda.
Nutritional Epidemiology
Faculty Contact: Sameneh Farsijani, PhD, RD
- Nutritional epidemiology explores how diet, eating behaviors, and biological responses to nutrition influence health and disease across the life course. This area bridges traditional diet-disease relationships with emerging approaches that incorporate omics, life course modeling, and personalized nutrition.
- Areas of research broadly include: Precision nutrition; chrononutrition (timing of intake, time-based diets, and intermittent fasting); calorie restriction; nutrition and aging; muscle health and sarcopenia; frailty and body composition; gut microbiome, nutrigenomics, metabolomics, and multi-omics integration; development of age- and sex-specific dietary recommendations; maternal and perinatal nutrition including optimal weight gain and micronutrient intake in pregnancy (e.g., vitamin D); food insecurity and health disparities; simulation of clinical trials, trial emulation, and application of causal inference and advanced statistical methods to nutritional data; obesity and metabolic diseases including diabetes and cardiovascular disease.
- Training opportunities include independent study and mentored research using large cohort and clinical trial datasets. A new course (EPIDEM 2560 – Nutritional Epidemiology) is planned for 2027, providing practical training in dietary assessment, diet quality metrics, biomarker use, and interpretation of diet-health relationships.
- Faculty members currently working in this area include: Lisa Bodnar, Tina Costacou, Tamara Dubowitz, Sameneh Farsijani, Nancy Glynn, James Matuk, Megan Marron, Iva Miljkovic, Akira Sekikawa, Elsa Strotmeyer, and Jian-Min Yuan.
Population Neuroscience
Faculty Contact: Caterina Rosano, MD, MPH
- Focuses on the application of epidemiology methods, neuroimaging, neuropsychological assessment and -omic methodologies in population and clinical studies, with the goal to advance etiological research in the disorders of the central nervous system due to aging or diseases.
- Targets the interdependent nature of clinical characterization, epidemiological methods, and multimodal assessment of disorders of the central nervous system through rigorous academic training and applied research opportunities.
- Maximizes the potential for applied research training and for successful field placements of the trainees through multidisciplinary mentored work with leaders in the fields of epidemiology, psychiatry, neuroscience, neurology, and others.
- Training Grant: Population Neuroscience with a focus on aging related dementia: 3 pre-docs, 2 post-docs. Research grants of individual faculty support post- and pre-docs positions to work on a variety of topics, including traumatic brain injury and women's health.
- Faculty members with primary appointment in Epidemiology working in this area include: Caterina Rosano, Andrea Rosso, Iva Miljkovic, and Seyoung Kim.
- Faculty members with secondary appointments in Epidemiology working in this area include: Beth Shaaban (Nursing), Janet Catov (Obstetrics, Gynecology & Reproductive Sciences), Mary Ganguli (Psychiatry) and Rebecca Thurston (Psychiatry).
- Collaborators from other departments include: Beth Snitz (Neurology), Zongqi Xia (Neurology), Lana Chahine (Neurology), Peter Gianaros (Psychology), Anna Marsland (Psychology), Ann Cohen (Psychiatry), Oscar Lopez (Neurology), Howard Aizenstein (Geriatric Psychiatry), and Meryl Butters (Psychiatry).
- For a full list of projects click here, and to learn more about our trainees, click here
Prevention, Lifestyle, & Physical Activity Epidemiology
Faculty Contact: Bonny Rockette-Wagner, PhD
- This Area of Emphasis involves training and research translating the proven benefits of lifestyle intervention on a broad range of health outcomes including type 2 diabetes, cardiovascular disease, and obesity. This program encompasses the conceptual and practical foundation needed for such public health translation initiatives. Learning objectives include a thorough understanding of the epidemiological basis for disease prevention, as well as behavioral intervention theory, and lifestyle intervention training, along with a critical understanding of the methodological issues in designing and evaluating these efforts.
- The faculty involved in this Area of Emphasis in the Department of Epidemiology are widely diverse in their focus, expertise and resulting funded research studies. Under the umbrella of prevention, lifestyle intervention and movement, examples of the resulting recent studies developing from these diverse focus areas include the PHRESH Study, the Diabetes Prevention Program and Translation Efforts; Study of Muscle, Mobility, and Aging; Psychosocial Issues and Bariatric Surgery; Physical Activity and Sedentary Behavior Change; Epidemiology of Diabetes Complications; Cognitive Decline, Brain Aging, Physical Environment & Mobility; Task Specific Timing and Coordination Exercises in Older Adults; the Study of Women’s Health Across the Nation (SWAN); and Lifestyle Intervention in Clinical Settings.
- Faculty members currently working in this area include: Lisa Bodnar, Jennifer Brach (Physical Therapy), Tamara Dubowitz, Samaneh Farsijani, Tiffany Gary-Webb, Nancy Glynn, Marquis Hawkins (Psychology), Wendy King, Andrea Kriska (Emeritus), Kathleen McTigue (Medicine), Iva Miljkovic, Anne Newman (Emeritus), Andrea Rosso, Trevor Orchard (Emeritis), Bonny Rockette-Wagner, Elsa Strotmeyer and Jian-Min Yuan.
Reproductive, Perinatal, & Pediatric Epidemiology
Faculty Contact: Dara Mendez, PhD, MPH
- Areas of research broadly include: fetal origins of disease; maternal and child health inequities; causes of pregnancy complications and adverse outcomes including spontaneous abortion, stillbirth, preterm birth, low birth weight, intrauterine growth restriction, and preeclampsia; obesity and nutrition among pregnant women; fertility and contraception; breastfeeding; sexually transmitted infections; and maternal substance use. Major clinical sites for collaboration include The Midwife Center, UPMC Children's Hospital of Pittsburgh, and Magee-Womens Hospital, the obstetrics, gynecologic, and reproductive sciences specialty hospital associated with the University of Pittsburgh Medical Center. Global health research experiences are available through a study of pregnancy being conducted in India. Community-partnered research opportunities are available as part of The EMBRACE Maternal Health Research Center of Excellence and The Pittsburgh Study.
- The training program provides concentrated, tailored training on the patterns, risk factors, and interventions that might improve reproductive, perinatal, and pediatric health, as well as women's health across the lifespan. All trainees will participate in coursework, research field work, and professional development including courses in EPIDEM 2719 Reproductive Epidemiology, EPIDEM 2709 Epidemiology of Women's Health, and EPIDEM 2310 Psychiatric Epidemiology (includes a Pediatric Epidemiology focus); a Maternal and Child Health Equity Scholars group; independent research; grant writing; manuscript preparation; and scientific conference presentations. The training program includes collaboration with the Maternal and Child Health Training Center of Excellence and the MCH Certificate Program led by Theresa Chapple-McGruder (HPM).
- Faculty members currently working in this area include: Lisa Bodnar, Janet Catov (Obstetrics, Gynecology & Reproductive Sciences), Natacha De Genna (Psychiatry), Catherine Haggerty, Dara Mendez, James Roberts (Obstetrics, Gynecology & Reproductive Sciences), Martina Anto-Ocrah (Medicine & Epidemiology), and Sonja Swanson.
Social Epidemiology and Health Equity
Faculty Contact: Tamara Dubowitz, SM, MSc, ScD
- Areas of research broadly include: Neighborhoods, maternal and child health, chronic disease including obesity and nutrition, interpersonal violence and behavior disorders, gun injuries, walkability, cognition and aging, substance and alcohol use, and systems science.
- Courses in Social Epidemiology include EPIDEM 2130 – Foundations in Social Epidemiology (to be offered Fall 2026) as well as a Methods in Social Epidemiology course in development to be offered by Spring 2027.
- Other training related to this area of emphasis include the Health Equity Certificate (Jason Deakings, Director), Center for Health Equity (Theresa Chapelle-McGruder), and MCH Equity Scholars Program (Dara Mendez, Director)
- Ongoing Studies and Initiatives in the Department
- Black Equity Coalition (Dara Mendez and Tiffany Gary-Webb)
- Equity in Maternal and Birthing Outcomes and Reproductive Health through Community Engagement (EMBRACE) (Dara Mendez)
- STudy of Racial Equity Among Medicaid Recipients (STREAMR) – Drs. Dara Mendez and Marian Jarlenski (HPM)
- Pittsburgh Hill/Homewood Research on Neighborhood Change and Health (PHRESH) – Drs. Tamara Dubowitz and Andrea Rosso
- Neighborhoods, Environments, and Systems Collaborative (NEST) (Tamara Dubowitz and Stina Mair) - Launched in 2025, NEST's mission is to enhance research, collaboration, and action around social determinants of health at the University of Pittsburgh School of Public Health. NEST's emphasis is on upstream determinants of health with a particular interest in policy, systems, and environments.
- Faculty members currently working in this area include: Tamara, Dubowitz, Anthony Fabio, Tiffany Gary-Webb, Stina Mair (Behavioral and Community Health Sciences), Dara Mendez, and Andrea Rosso.
Women's Health Epidemiology
Faculty Contact: Maria Brooks, PhD
- Areas of research broadly include: women’s health across the lifespan, pregnancy, maternal and child health and adverse pregnancy outcomes and women at late life. Menopause and Aging focuses on furthering our understanding of chronological aging versus ovarian aging. Emphasis is placed on a broad range of topic areas including the musculoskeletal health, reproductive health, cardiovascular disease, cancer, mental health, physical function and disability, body composition, and lifestyle.
- Examples of specific research include the following:
- Healthy weight and dietary intake as they affect maternal and child health;
- Black women’s health across the life course and equitable approaches to centering women from marginalized populations;
- Sleep, physical activity and cardiovascular disease (CVD) in women during and after pregnancy;
- Early pregnancy origins of exposure related risk to the long-term health of the child by studying the placenta as a relevant mediator of the effects of maternal exposure e.g. endocrine disrupting chemicals called phthalates and effects on fetal development;
- Adverse pregnancy outcomes and the development of CVD outcomes in later life;
- Mechanisms linking the menopausal transition, sex hormones, lipids, ectopic fat deposition, and subclinical measures of CVD;
- Aging including the study of risk factors and sequelae of frailty, physical and cognitive disability in women;
- Studies of key outcomes in older women including fractures, CVD, falls, cancer and mortality;
- Key Studies/resources of Women’s Health AOE:
- Study of Women’s health Across the Nation (SWAN);
- Study of Osteoporotic Fractures (SOF);
- The Women’s Health Initiative (WHI);
- Magee Obstetric and Infant database (MOMI);
- Medicare Linkage of our cohorts
- Courses:
- EPIDEM 2709 Epidemiology of Women’s Health
- EPIDEM 2719 Reproductive Epidemiology
- EPIDEM 2725 Reproductive Development from Model Organisms to Humans
- Faculty members currently working in this area include: Lisa Bodnar, Maria Brooks, Janet Catov (Obstetrics, Gynecology & Reproductive Sciences), Alicia Colvin, Natacha De Genna (Psychiatry), Tamara Dubowitz, Catherine Haggerty, James Matuk, Dara Mendez, Kristine Ruppert, Akira Sekikawa, and Rebecca Thurston (Psychiatry).