When is it appropriate to refer a patient to a specialist?

If patients diagnosed with unipolar depression do not show an adequate response after approximately six weeks of treatment with an antidepressant, a referral to private-practice psychiatrists or specialized outpatient treatment centers should be arranged. Other reasons for referral include severe depressive disorders, acute suicidal ideation, danger to others, and psychotic symptoms. It may also be advisable to consult specialists if bipolar disorder is suspected, if there are complex comorbidities, or if there is uncertainty regarding the distinction from organic causes.