Fifty-eight consecutive suicides between 15 and 29 years of age occurring in Göteborg, Sweden, were assessed in accordance with DSM-III Axis V (highest level of adaptive functioning in the past year). The levels of adaptive functioning were compared to principal Axes I and II disorders. Subjects with a borderline personality or schizophrenic disorder as the principal disorder tended to have poor to very poor adaptive functioning and were frequently associated with substance abuse (19 of 24 subjects). Subjects with adjustment disorder or major depressive disorder as the principal disorder generally had very good to fair adaptive functioning. Clinicians are reminded that apparently higher functioning as defined by DSM-III Axis V is no insurance against suicide.