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Participants were evaluated with an in\u2010person assessment of their cognitive functioning, medical illnesses, and other clinical domains. Natural cause mortality through 2022 was determined with data from the National Death Index. Cox proportional hazards models were employed to determine factors contributing to natural cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 553 persons in the study population had a mean age of 35.7 (SD13.0) years; 409 (74.0%) were White; 104 (18.8%) Black; 167 (30.2%) were male sex. The mean follow\u2010up duration was 12.7\u2009years (range 1.9\u201321.5). A total of 39 (7.1%) individuals died of natural causes such as cancer and cardiac disorders. The most significant predictor of natural cause mortality was a history of recent homelessness (HR 6.02, 95% CI 2.56, 14.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additional baseline factors independently associated with mortality included a diagnosis of type 2 diabetes (HR 3.67, 95% CI 1.67, 8.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), tobacco smoking (HR 2.99, 95% CI 1.57, 6.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and lower cognitive functioning (HR 0.97, 95% CI 0.95, 0.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this prospective study of persons with bipolar disorder, a history of recent homelessness was a strong risk factor for natural cause mortality. Efforts should be directed at preventing homelessness, improving cognitive functioning, promoting smoking cessation, and managing diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70092","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T08:59:28Z","timestamp":1771577968000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Natural Cause Mortality in Bipolar Disorder"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-2864","authenticated-orcid":false,"given":"Faith","family":"Dickerson","sequence":"first","affiliation":[{"name":"Stanley Research Program Sheppard Pratt  Baltimore Maryland 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