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Paul S. Appelbaum, MD

@appelbap.bsky.social
203 followers 16 following 32 posts

Dollard Professor of Psychiatry, Medicine & Law, Columbia University. Interested in medical ethics, ELSI of genetics and neuroscience, law and psychiatry, mental health policy.

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Reposted by Paul S. Appelbaum, MD
ELSIhub | CERA @elsihub.bsky.social · 14/05/2026
Join our next free online ELSI Journal Club discussing: 📄 “What do we mean by actionability? Examining a key criterion in genomic prenatal and newborn screening” The article has been made Open Access for this session. 🗓 May 29 | 12 PM ET / 9 AM PT Register: evt.to/edguoggdw #ELSI #Bioethics
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Paul S. Appelbaum, MD @appelbap.bsky.social · 22/03/2026
TV and movies have tremendous power to shape our behavior in the real world. Here Joe Nocera calls out "Shrinking" for condoning (and maybe even promoting) therapists' harmful boundary violations: www.thefp.com/p/bad-therap...
thefp.com
Bad Therapists Make Good TV. But at What Cost?
The therapists in ‘Shrinking’ cross nearly every possible boundary with their patients—and that’s a really bad thing, writes Joe Nocera.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 08/02/2026
Think keto is promising? Let's see what the controlled trials have to say. www.nytimes.com/2026/02/06/u...
nytimes.com
Psychiatrist Says Kennedy Was ‘Not Accurate’ in Discussing His Keto Studies
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Paul S. Appelbaum, MD @appelbap.bsky.social · 05/02/2026
My take: it is “simply misleading to suggest that we know that ketogenic diets can improve schizophrenia symptoms, much less that they can ‘cure’ the condition.” www.nytimes.com/2026/02/05/u...
nytimes.com
Kennedy Makes Unfounded Claim That Keto Diet Can ‘Cure’ Schizophrenia
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Paul S. Appelbaum, MD @appelbap.bsky.social · 22/01/2026
Case reports begin to accumulate of people experiencing psychotic symptoms after intensive interactions with chatbots. Like this woman who experienced delusions of communicating with her dead brother after late-night chatbot sessions: www.livescience.com/health/diagn...
livescience.com
Diagnostic dilemma: A woman experienced delusions of communicating with her dead brother after late-night chatbot sessions
A woman developed psychosis, and her symptoms escalated rapidly, prompting clinicians to retrace the events leading up to her hospitalization.
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Reposted by Paul S. Appelbaum, MD
Columbia Ethics @columbiaethics.bsky.social · 21/01/2026
New Publication by faculty affiliate Matthew Lebowitz and @appelbap.bsky.social How do people decide when genes matter for behaviors? The authors find a consistent asymmetry and the psychological mechanisms behind it 👇
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Reposted by Paul S. Appelbaum, MD
Margot van de Weijer @margotvdweijer.bsky.social · 08/01/2026
The updated version of this paper is now online: rdcu.be/eX8ck. We wrote this paper as part of the behavior genetics special issue 'Behavioral Genetics as a Public Science: Impacts and Implications' -excited to see it out! @evangiangrande.bsky.social @lucasjmatthews.bsky.social @appelbap.bsky.social
link.springer.com
Imputing Parental Genotypes Through Mendelian Imputation: Ethical and Legal Considerations - Behavior Genetics
Mendelian imputation is a promising method for imputing missing parental genotypes and estimating direct and indirect genetic effects. While the method has clear scientific benefits, so far there has ...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 04/12/2025
A nice summary, with comments by my colleague Matt Lebowitz, of our research on perceptions of genetics as the cause of good and bad behaviors: www.psypost.org/why-people-t...
psypost.org
Why people think kindness is in your DNA but selfishness isn’t
A new study in Public Understanding of Science finds that people tend to see good behavior as more genetically caused than bad behavior, mainly because kindness and generosity are perceived as more na...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 14/11/2025
At the Univ. of Virginia, the Institute of Law, Psychiatry & Public Policy is conducting an oral history project on mental health & law to mark its 50th anniversary. Check out my recollections here: avalon.lib.virginia.edu/media_object...
avalon.lib.virginia.edu
Oral History Interview with Paul S. Appelbaum - Avalon Media System
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Reposted by Paul S. Appelbaum, MD
Columbia Ethics @columbiaethics.bsky.social · 31/10/2025
New Publication from our faculty affiliate, @appelbap.bsky.social Can a person still claim the insanity defense if their mental state was affected by not taking prescribed medication? 📘doi: 10.1176/appi.ps.20250438
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Reposted by Paul S. Appelbaum, MD
ELSIhub | CERA @elsihub.bsky.social · 29/10/2025
This Friday! Join our Journal Club to discuss the implications of subcontinental genetic variation.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 28/10/2025
“...the available data do not suggest that SSRIs make them more likely to engage in mass shootings. Indeed, to the extent that SSRIs alleviate their distress, they may reduce the risk of violence.” www.factcheck.org/2025/10/rfk-...
factcheck.org
RFK Jr. Misleads About Antidepressants and School Shootings - FactCheck.org
A day after a shooting at a school in Minnesota, Health and Human Services Secretary Robert F. Kennedy Jr. claimed, as he has before, that certain antidepressant drugs, known as SSRIs, “might be contr...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 17/09/2025
An excellent overview of laws on involuntary commitment of drug users. As I said, “Passing a law doesn’t create a system. Treatment of addiction is difficult and takes time. It is not something that’s going to be solved in 30 days.” www.nytimes.com/2025/09/17/h...
nytimes.com
Can Drug Users Be Forced Into Rehab? Trump Says Yes. So Do 34 States.
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Reposted by Paul S. Appelbaum, MD
Columbia Ethics @columbiaethics.bsky.social · 07/08/2025
🧬 What happens when a genetic therapy is made for just one patient? How do we support and regulate development? @sandrasoojinlee.bsky.social and @appelbap.bsky.social from our Division discuss the ethical implication of “research-treatment hybrids”. 🔗https://jme.bmj.com/content/51/5/jme-2023-109729
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Reposted by Paul S. Appelbaum, MD
Margot van de Weijer @margotvdweijer.bsky.social · 01/08/2025
New pre-print online: Imputing parental genotypes through Mendelian Imputation: Ethical and Legal Considerations osf.io/preprints/ps...
osf.io
OSF
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Paul S. Appelbaum, MD @appelbap.bsky.social · 29/07/2025
An important alert on the implications of an Executive Order on "gold standard science" that many of us may have missed: www.thehastingscenter.org/gold-dust/
thehastingscenter.org
Gold Dust : The Hastings Center for Bioethics
The United States has never had a situation in which political and ideological nonscientists got the last word about what is credible science. The direct political oversight of science represented in ...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 23/07/2025
What do we know about how mental illness affects pretrial defendants' chances of reoffending or failing to appear for trial? Answer: Not very much. See our new article: A Scoping Literature Review of Mental Illness in Decisions Regarding Pretrial Release jaapl.org/content/earl...
jaapl.org
A Scoping Literature Review of Mental Illness in Decisions Regarding Pretrial Release
Judges generally make pretrial release decisions based on the risk that a defendant will miss court appearances or pose a danger to the community; for criminal cases initiated in state courts, this de...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 16/07/2025
Our analysis of the impact of abortion restrictions on mental health in pregnancy, just out today: :https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2836537?utm_source=bluesky&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=071625
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Paul S. Appelbaum, MD @appelbap.bsky.social · 10/07/2025
Our systematic review or the literature on the psychosocial impacts of autism-related genetic testing is now online (in preprint format) at JAACAP: doi.org/10.1016/j.ja...
sciencedirect.com
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Paul S. Appelbaum, MD @appelbap.bsky.social · 05/06/2025
The capacity of newborn genomic screening to identify risks for conditions without effective treatments, along with diseases that may develop much later in life, can create challenges for parents and offspring alike: www.nytimes.com/2025/06/05/h...
nytimes.com
The Ethical Minefield of Testing Infants for Incurable Diseases
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Paul S. Appelbaum, MD @appelbap.bsky.social · 05/06/2025
The new American Law Institute Restatement on Medical Malpractice portends changes in how the courts assess clinician liability, with more emphasis on evidence-based care. Neil Kaye and I discuss here: psychiatryonline.org/doi/epdf/10....
psychiatryonline.org
Psychiatry Online
PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 19/05/2025
Most firearms used in mass shootings in the US are legally acquired--and legal guns are associated with higher number of fatalities. Another reason why focusing exclusively on illegal possession won't stop the violence epidemic. onlinelibrary.wiley.com/doi/10.1111/...
onlinelibrary.wiley.com
An analysis of firearm legality and lethality in 625 U.S.‐based mass murders involving firearms
Understanding the relationship between firearm regulations and the lethality of mass murder involving firearms has implications for prevention efforts. We examined 625 incidents of mass murder involv...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 14/05/2025
Flying under the radar, HHS announces it no longer intends to enforce mental health insurance parity rules. The inevitable result: markedly reduced access to treatment. www.statnews.com/2025/05/13/h... via @statnews
statnews.com
Mental health care may be harder to obtain after HHS rule reversal
Access to care could be affected, following HHS indication that it will not enforce updates adopted in 2024 to the mental health parity law.
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Reposted by Paul S. Appelbaum, MD
Jordan Smoller @jorsmo.bsky.social · 07/05/2025
"let’s be clear: It isn’t institutions that are being punished. It’s the researchers who are the future of science in this country" What am I supposed to say to this generation of young scientists? www.statnews.com/2025/05/07/u... via @statnews.com
statnews.com
What am I supposed to say to this generation of young scientists?
Undermining the future of American science is not a path to accountability — it’s a path to decline.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 04/05/2025
No one dies of "complications of schizoaffective disorder." Disturbing questions about the quality of care rendered people in ICE custody, including people with mental illness: www.miamiherald.com/news/local/i...
miamiherald.com
Two men in ICE custody died of ‘natural’ causes. Were their deaths preventable?
Top medical experts reviewed records and questioned the treatment two immigrants received before their deaths. “That’s certainly substandard care,” said one neurologist.“That’s certainly substandard c...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 01/05/2025
In this new article, Stephanie Rolin and I review the expansion of liability for colleges and universities in addressing students with mental health issues: rdcu.be/ekaDC
rdcu.be
Expansion of Colleges’ Legal Responsibilities Regarding Student Mental Health
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Paul S. Appelbaum, MD @appelbap.bsky.social · 17/04/2025
To what extent should childhood abuse be taken into account in sentencing for murder of the abuser? The Menendez brothers' case is dealing with exactly that question: www.thefp.com/p/the-menend...
thefp.com
Were the Menendez Murders Justified?
Increasingly, judges are giving lighter sentences to criminals who suffered abuse during childhood. That could be good news for the Menendez brothers.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 03/04/2025
A study of AI chatbots for treatment of mental disorders has gotten attention recently, but we should restrain our enthusiasm until some key questions are answered: selection bias? appropriate control? duration of effect? human supervision required? www.medscape.com/viewarticle/...
medscape.com
Mental Health AI Chatbot Rivals Human-Based Tx in Less Time
A generative AI–powered therapy chatbot is linked to significant reductions in symptoms of depression, anxiety, and eating disorders, results of a randomized controlled trial show.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 26/03/2025
Social isolation and loneliness are common problems that bring people into psychiatric treatment--and are widely prevalent outside of treatment settings as well. Clinicians need to pay more attention to these factors and help patients break the cycle of isolation. www.medscape.com/viewarticle/...
medscape.com
Lonely Planet: How the World Is Fighting Social Isolation
Loneliness has become a global health crisis, linked to depression, dementia, and early death. With over a billion people affected, how are countries working to reconnect us?
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Reposted by Paul S. Appelbaum, MD
Jordan Smoller @jorsmo.bsky.social · 13/03/2025
How the NIH dominates the world’s health research — in charts www.nature.com/articles/d41...
nature.com
How the NIH dominates the world’s health research — in charts
Abrupt cuts by the Trump administration to the US National Institutes of Health threaten progress in medical research globally.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 28/02/2025
A fascinating and terrifying look inside the chaos at NIH--and an answer to the question of why, despite court orders, grant funding has not started flowing again: www.theatlantic.com/health/archi...
theatlantic.com
Inside the Collapse at the NIH
Administration officials pressured the NIH to avoid clear advice from the agency’s own lawyers to restart grant funding now.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 10/02/2025
[Off-topic alert] The loss of geographic mobility in America and its effect on economic prosperity, social solidarity, and political polarization. The Atlantic's March cover story, adapted from my son Yoni's new book: www.theatlantic.com/magazine/arc...
theatlantic.com
How Progressives Froze the American Dream
The U.S. was once the world’s most geographically mobile society. Now we’re stuck in place—and that’s a very big problem.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 28/01/2025
PubMed, the indispensable online index of medical literature--essential for all types of medical research--seems not to be accessible. Another effect of the freeze of federal funding? What's next? pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
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Paul S. Appelbaum, MD @appelbap.bsky.social · 08/01/2025
This report on the effort to characterize psychiatric treatment of some chronic disorders as "palliative care" includes my thoughts on why that's a really bad idea. psychiatryonline.org/doi/10.1176/...
psychiatryonline.org
Is There a Role for Palliative Care of Severe and Chronic Mental Disorders? | Psychiatric News
PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.
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Paul S. Appelbaum, MD @appelbap.bsky.social · 10/12/2024
Very interesting look at how treatment expectancies for psilocybin vs escitalopram for depression affected a trial outcome. Spoiler: the psychedelic was only superior for patients with low expectations for the antidepressant. jamanetwork.com/journals/jam...
jamanetwork.com
Treatment Expectancies and Psilocybin vs Escitalopram for Depression
This randomized controlled trial secondary analysis examines the association between treatment expectancies and the relative efficacy of psilocybin compared with escitalopram for major depressive diso...
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Paul S. Appelbaum, MD @appelbap.bsky.social · 27/11/2024
The UK is considering a bill legalizing physician-assisted death (likely being considered this week). I joined a number of colleagues in noting that the provisions would allow patients with treatable eating disorders to qualify, poor public health policy: www.bmj.com/content/387/...
bmj.com
Re: Assisted dying laws around the world: Proposed UK Assisted Dying Bill Fails the Public Safety Test
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Paul S. Appelbaum, MD @appelbap.bsky.social · 20/11/2024
Manufacturers of drugs or devices don't have to disclose risks directly to patients because of the “learned intermediary rule.” But the Calif. Supreme Court recently expanded the ways patients can get compensated for undisclosed risks. My latest: psychiatryonline.org/doi/10.1176/...
psychiatryonline.org
Electroconvulsive Therapy, Manufacturers’ Liability, and Learned Intermediaries | Psychiatric Services
Manufacturers of drugs or devices that are prescribed by physicians are protected by the “learned intermediary rule” from having to disclose risks directly to patients. Instead, they must inform physi...
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