After growing up in Manhattan, Rapoport graduated magna cum laude with a B.A. in Experimental Psychology from Swarthmore College, and was then admitted to Harvard Medical School as only one of five women in her class. Yet some instructors blamed her for “taking the space of a male physician.” She received her M.D. after four years there — and met her husband, Dr. Stanley Rapoport. But she wasn’t done yet: she did her internship at Mount Sinai Hospital in New York, then completed psychiatric residencies at Massachusetts Mental Health Center in Boston and St. Elizabeths Hospital in Washington, D.C. She also trained at the National Children’s Hospital in Washington, D.C., and at Karolinska University Hospital in Stockholm, Sweden.
But after all that training and experience, she realized she didn’t want to be a psychoanalyst. She took a position at the National Institutes of Health in the mid-1960s, and stayed there for the rest of her career. It allowed her to pioneer longitudinal studies in psychiatry — observing children as they aged, running them through tests and observation. Two of her longtime volunteers: her own two sons.
In school, Rapoport had learned about Obsessive-Compulsive Disorder, which was thought to be very rare. But by the 1970s, after treating hundreds of children and teens with OCD (which presumably did not include her own sons), she realized it was much more common than anyone thought. In 1984, she was made Chief of the newly established Child Psychiatry Branch within the NIH’s National Institute of Mental Health. Between her clinical experience and her studies, she wrote a book about OCD for a lay audience. The Boy Who Couldn’t Stop Washing (The Experience and Treatment of Obsessive-Compulsive Disorder) * was published in 1989, and has never gone out of print. “What I’m most proud of,” Dr. Rapoport said in 2002, “is that the book demonstrated that OCD, which had been considered very, very rare, was more common than bipolar disorder or schizophrenia.”
The news show 20/20 did a segment on the book, leading to 250,000 worried parents calling ABC after it ran, worried that their children had the disorder. Dr. Rapoport said many of those parents were being overly reactive — but a lot of them were right: their kids had OCD. One of her studies, published in 1985, showed that there was an effective drug to help: Clomipramine. In 1989 it became the first drug approved by the FDA to treat OCD, though other drugs are now the first choice due to having fewer side effects.
But her primary point was to show that OCD was real, had triggers, and could be treated. Her role in “biological psychiatry” is foundational. At a time when many clinicians still viewed childhood conditions as primarily environmental or behavioral, she showed that disorders like OCD and ADHD have neurological and genetic components, not just psychological ones. “Judy helped turn child psychiatry into a modern medical discipline that was grounded in neuroscience and evidence-based treatments,” says Dr. Gabrielle Shapiro, a child and adolescent psychiatrist and Professor of Clinical Psychiatry at the Icahn School of Medicine at Mount Sinai in New York.
With her studies, Rapoport’s work in biological psychiatry linked physical brain structures to behavior. CT (and later MRI) scans showed measurable differences in brain structures (especially frontostriatal circuits): there were correlations between those differences and specific symptoms. Her longitudinal studies followed children over years, sometimes decades, to show how disorders evolve over time, helping to reveal which children improve, persist, or change diagnoses, and how biology interacts with development. Her approach is now standard in the field, but she was one of the early leaders in doing it rigorously. She retired in 2017. Judith Livant Rapoport, MD, died in a retirement home in Washington D.C. on March 7. She was 92.