Eighteen psychiatric inpatients who fulfilled DSM-III criteria for major depression and who had a positive dexamethasone suppression test after admission were later retested. Of the 13 patients who exhibited cortisol suppression at discharge, two relapsed within 6 months; five remained nonsuppressors at discharge, and all either required further inpatient care or were symptomatic within 2 weeks to 4 months. Continued cortisol nonsuppression was thus associated with poor clinical response or high risk of relapse.