The ability to effect change is rooted in commitment, dedication, and passion. Changemakers harness their ability to be disrupters, with their belief that a world in need of help is worthy and deserving of impactful contributions for the betterment of society.
For over 64 years trailblazing UIC Psychiatrist John M. Davis has embodied these principles, and garnered significant acclaim and numerous awards throughout his career journey. Despite these accolades, it’s his tireless advocacy of many and varied humanitarian efforts in mental health, and devotion to the championing of young scientific investigators, that stands as his greatest achievement. In this issue of the UICDR newsletter we profile the prolific career of the pioneering scientist Dr. Davis, his research and continued legacy of work at UIC’s Department of Psychiatry.
Beginnings at a new frontier
Dr. Davis attended Princeton University, received his medical degree from Yale University School of Medicine, interned at Massachusetts General Hospital, and returned to Yale for his psychiatric residency. Early in his college career Dr. Davis was exposed to how newly discovered drugs could treat mental health conditions such as schizophrenia.
“I was a psychology major in college and worked one summer collecting data on a psychological test given to severely mentally ill hospitalized patients for one of my professors. Psychotropic drugs had just been discovered and at the time the effects of medications on the body weren’t fully known. But I had observed how these medications were emptying out the state hospitals”, says Dr. Davis. This experience would heavily influence his future research and career and inspired him to turn psychiatry into more of a clinical science.
“When I entered psychiatry, academic psychiatry was entirely psychoanalytic, schizophrenia was seen because of a bad mother. If a resident mentioned he used a drug he would be criticized for having to resort to a drug and not trusting his psychotherapeutic skills. I observed that drugs could produce a rapid improvement in patients”.
These beginnings led to Dr. Davis being at the forefront of pioneering psychiatric/depression research, as one of the first few researchers in psychopharmacology.
Psychopharmacology treatments brought about fundamental changes in the treatment of many major psychiatric disorders such as depression, mania, and schizophrenia, and were considered revolutionary.
From the diagnosis and categorization of psychiatric disorders, to resetting standards for modern psychiatry as a clinical and academic medical specialty, psychopharmacology has significantly impacted the landscape of mental health.
A career of firsts
Dr. Davis’s pioneering work in psychopharmacology has led to series of firsts throughout his career, including the first studies of how oral antipsychotic drugs are metabolized in their first pass through the liver and how this process may impact their efficacy and side effects. His work showed that the therapeutic doses were much lower than previously thought. His early research also included work on the involvement of the neurotransmitter dopamine in schizophrenia, leading to the development of partial dopamine blockers as antipsychotic drugs. His first of its kind meta-analysis provided convincing evidence that maintenance antipsychotic, mood stabilizers and antidepressant drugs could help prevent future schizophrenic episodes.
Other firsts included the early formulations of the biogenic amine hypothesis of depression, as well as writing the first science-based textbook on psychopharmacology that served as a guide for psychiatrists seeking to use medications more effectively.
The influence of diet on depression
Another area of Dr. Davis’s research focuses on the influence of diet on depression, and the role of the omega-3 essential fatty acids in health and diseases.
“There have been many investigations on whether diets that contain fish oil, which is high contents of omega-3 essential fatty acids, benefit depression. I did a meta-analysis of studies and found that most studies that administered one type of fatty acid (EPA), which does increase brain omega-3 essential fatty acids, consistently had a greater antidepressant effect than placebo in patients with clinical depression.”
Dr. Davis, in collaboration with Joseph R. Hibbeln, M.D. (a UIC medical school graduate), and Jean Golding OBE, FMedSci, discovered children of mothers who do not eat fish have lower IQs than those who do. This work on the role of adequate dietary intake of omega-3 fatty acids has resulted in changes to the FDA dietary guidelines to recommend fish for pregnant women and the 2015 Dietary Guidelines for Americans.
Currently Dr. Mark Rasenick of the University of Illinois Center on Depression and Resilience (UICDR) has continued such research. Building on Dr. Davis’s findings, Dr. Rasenick’s work demonstrated that in stem cells from depressed patients, omega-3 fatty acids facilitate astrocyte differentiation and suggested a molecular pathway for the actions of n-3 PUFA. Together, these results suggested that omega-3 fatty acids (Omega-3 fatty acids are “healthy fats” that have many potential benefits for your cardiovascular health, and are found in foods, such as fish and flaxseed, and in dietary supplements, such as fish oil) facilitate astrocyte differentiation and may mimic the effects of some antidepressants by increasing the production of neurotrophic factors. The CREB-dependence and cAMP independence of this process suggests a manner in which n-3 PUFA could augment antidepressant effects. These data also suggest a role for astrocytes in both major depressive disorder and antidepressant action, like antidepressants, increase the production of neurotrophic factors.
Building the future in psychiatry
The field of Psychiatry is currently at a crossroads, faced with the continued stigma attached with mental health treatment, and the need for the science of psychiatry to evolve. Removing the stigma attached to mental illness is contingent upon the science recognizing and meeting the needs of society.
The role of advanced treatments plays a pivotal role in destigmatizing mental health treatment, and bringing it into the mainstream of medical research, healthcare, education, and public policy, which has been championed by Dr. Davis throughout his career.
“The future of psychiatry continues to evolve. Psychiatry changed from psychoanalytic to more biologically based as psychoanalysts retired from imported administrative posts to be replaced by more biologically oriented psychiatrists”, says Dr. Davis.
“The fact that many mental illnesses can be treated with drugs helped place psychiatric illnesses more firmly as a medical illness, treatable with medications. I feel that conceptualizing depression as a chemical imbalance in the brain has contributed to destigmatizing depression.”
“As we increase our knowledge and understanding of psychiatric disorders, it is imperative we meet the needs of society head on. Psychopharmacology helped “normalize” a means of mental health treatment by linking the efficacy of antidepressants to a possible cause of depression, providing a rationale for their use.”
Building a legacy
For the past 38 years, Dr. Davis has been a researcher in UIC’s Department of Psychiatry. This time has given him the opportunity to reflect on what distinguishes UIC’s psychiatry department from others.
“It truly is a leading institution of psychiatric academic/research. Well-funded by NIH, with diverse programs, from practical interventions to basic research, including a major NIAAA center of the investigation of alcoholism,” says Dr. Davis.
“The department was the first to explore the role of epigenetics in mental disease, one of the major advances of recent years. It has done important work on the role of neurosteroids in brain functions, contributing to new treatment for postpartum depression, one of the leading centers of women issues, which has made contributions to understand dysfunctions related to the menstrual cycle. Relevant to this, Drs. Alessandro Guidotti and Grazio Pinna have made critical extensions to the discoveries of Dr. Davis, on the bioamine hypothesis, to add neurosteroids as a mediator of depression and anxiety.“ Dr. Davis continues to be involved in this work.
Through his groundbreaking research, Dr. Davis continues to be an influential force in the psychiatry department. His selfless support of others has made it possible for those he’s mentored, colleagues throughout his career, as well as the university to advance care and support for the mentally ill.