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Psychosis: When to refer to a specialist

  • First presentation of psychotic symptoms
  • Diagnostic clarification and treatment
  • Severe presentation (safety risks to self or others, serious functional impairment, comorbid medical or substance use issues)
  • Refractory to standard treatment (two or more medication trials)
  • Acute decompensation
  • When considering the use of clozapine or ECT

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