Background: Severe depression has been associated with a high rate of recurrence and chronic course. However, little is known about the course of depression in the very long term.
Case Report: This study presents case reports of two women who had been admitted with severe depression in the 1950s and 1960s. The women, who had been inpatients at the Department of Psychiatry, Lund University Hospital, Lund, Sweden, were interviewed, and the interviews were supplemented with
studies of their case records. They were considered to have met the criteria for major depressive disorder with melancholic or psychotic features. Both of them had experienced different numbers of episodes without full inter-episode recovery. They had also made repeated suicide attempts, at least one being serious. Their depressed periods without full recovery lasted 16 and 29 years respectively. They then recovered and remained well for 30 and 25 years respectively.
Conclusions: A long-lasting full recovery is possible, even after a chronic course of severe depression with repeated suicide attempts.

Keywords: psychosis, melancholia, Depression, long-term follow up