In Response

This article features the response to the important commentary by Dr. Carlson. The Amish Study represents, as she notes, a special research population for investigation of "classic" bipolar disorder viewed against a homogeneous cultural landscape where emerging biological and behavioral prodromal features can be identified. Dr. Carlson questions "where are the bipolar offspring?" and suggests that this "should have been the thrust of this publication." The authors submit that their emphasis should not have focused on illness onset and morbid risk. This would have diverted them from their goal to report prospective data on characteristics and/or possible prodromal patterns before onset. In this article, the authors address Dr. Carlson's title question and clarify other equally important issues in the commentary.