When the Amish Study, which includes the cases reported here, began in 1976 it established a project Psychiatric Board of five clinicians charged with diagnosis of patient case materials using strict research diagnostic criteria (both RDC and DSM III–IV) blind to existing medical “treatment opinions” of practitioners and unaware of family relatedness. Each BPD case was re-evaluated blindly at least twice over the decades resulting in consensus diagnoses. Follow-up of BPD patients and their unaffected relatives for genetic research, including those used for the present study, was carried out yearly and has spanned 2–3 decades [23]. A second diagnostic procedure tracked course-of-illness by both the Board and a project Seasonality Panel comprised of three psychiatrists, who coded episodes that extended beyond 20–30 years for the patients in this study. Medical records documented the extent to which lithium was an effective mood stabilizing medication for the BPD patients used to generate iPSC lines. Data for 87 individuals from four large Amish families, the largest being core Pedigree 110, location of the present research subjects, has been described [24]. The project Board
