472 bipolar patients were followed up retrospectively over 17 years. The patients that died were compared with the general population and a control group. The former comparison showed greater mortality from suicide, cardiovascular and respiratory causes in the index population and the latter, that the deceased were more likely to have been unmarried, with greater frequency and duration of admissions, a shorter follow-up period and were less likely to have received lithium treatment. The suicides were significantly younger at onset and death than the index and control groups, and suicide was uncommon where follow-up extended over 10 years.