COM-P professor's passion for precision psychiatry is echoed in his second career as a jazz musician

Musicians John Coltrane and Ornette Coleman are free-form jazz legends, but an Egyptian-born psychiatrist at the College of Medicine – Phoenix may be laying his own claim to the genre.

Free-form jazz and psychiatry aren't often mentioned in the same sentence, but Ayman Fanous, professor of psychiatry and chair of the Department of Psychiatry, plays both the guitar and bouzouki, a long-necked stringed instrument popular in the eastern Mediterranean. About a year ago, he performed at American University's Tahrir Cultural Center in his native Cairo. His performance pulled from his latest album, "Negoum." The 2019 release, a collaboration with cellist Frances-Marie Uitti, offers a more regional free-form sound.

"Lubricity," a solo effort on the compilation album "I Never Metaguitar 5," explores melodies in a distinctly nonlinear fashion that acts like a psychotropic key to open up the mind's latent capabilities.

That's rather apropos considering Fanous is a psychiatrist.

Egypt, Utah and the East Coast

Growing up primarily on the East Coast, Fanous graduated from West Potomac High School, then went to the University of Virginia for his undergraduate work. He attended Virginia Commonwealth University for his medical degree. His path into medicine followed in the footsteps of his father, who was a urologist.

"I always wanted to be a doctor – not always a psychiatrist, but a doctor. It was just a natural thing with my dad, because of all the influence he had on me," Fanous said.

And, due to his own interest in philosophy and psychology, psychiatry and healing the mind-body nexus were a "perfect fit" for him.

At VCU, he was inspired by Kenneth Kendler, a pioneer in research on psychiatric genetics and related causes of schizophrenia, who became his mentor. 

Precision psychiatry

Schizophrenia, characterized by persistent delusions, hallucinations and disordered speech and thinking that impair daily function, affects about 1 in 300 people, or 24 million, globally, according to the World Health Organization. In the U.S., as many as 2.8 million people have the disorder, with up to 40% untreated in any given year.

"It leads to all kinds of disruptions, not just in terms of lost productivity, but also an inability to hold down jobs and maintain relationships," Fanous said. "And the suicide rate has just been out of control. We're talking about one of the largest public health problems."

Fanous says research into schizophrenia has come a long way since the 1990s. At that time, the medical community didn't know much about the genetics of the condition. But as technology advanced, researchers were able to begin really digging into the genome.

The Human Genome Project in 2003 led to the U.S. Department of Veterans Affairs Million Veteran Program in 2011 and National Institutes of Health All of Us Research Program in 2015. Both programs seek to amass genetic databases of 1 million or more people to accelerate research for precision medicine therapies.

Tapping into those efforts and similar data, Fanous has focused his career on psychiatric genetics and psychopharmacology, which led to posts as associate professor at Georgetown University and chief of the Psychiatric Genetics Research Program at the Washington (D.C.) VA Medical Center.

In 2016, he landed at the State University of New York Downstate Health Sciences University as psychiatry chair and associate director of the Institute for Genomic Health, where the Genomic Psychiatry Cohort database of 40,000 individuals allowed for large-scale genomic studies.

Building on a dream

Fanous calls his position at the College of Medicine – Phoenix his dream job. He was impressed by the college's leadership, resources, energy and alignment toward precision medicine – as well as city and state support for building a biomedical research hub.

"I realized this was a chance of a lifetime to start a research program or department from the ground up," he said. "It also seemed that there was a lot of potential energy and resources that could go into developing an area of psychiatry very near and dear to my heart, precision psychiatry, that I didn't have at my other institution. The alignment here was perfect."

He was attracted to the opportunity to continue collaborating with the Million Veteran Program through the VA Phoenix Health Care System and potentially work with the University of Arizona – Banner Health All of Us Research Program, the Translational Genomics Research Institute and the Banner Alzheimer's Institute.

He recently co-authored a paper that highlights a key advance in understanding schizophrenia, published in the journal Nature, that discusses the largest-ever genetic study of the disorder. Using data from the Psychiatric Genomics Consortium, researchers analyzed DNA from 76,755 people with schizophrenia and 243,649 without it and identified nearly 300 genomic regions and 120 specific genes tied to the illness.

"That was a watershed moment," Fanous said. "We're at the stage that we're now able for the very first time to identify some of the biological pathways leading to schizophrenia, based on our understanding of the genetics. It's a really exciting time."

Fanous even thinks about genetics in his music, which he considers a second career. A jazz track on his 2013 album "Zilzal," recorded with violinist Jason Kao Hwang, is titled "DNA: Binding Sights."

You can listen to Fanous' music on his Soundcloud page.

A version of this article originally appeared on the Health Sciences Connect website.