Patient selection: woman with postpartum depression
Reasons to refer the patient to a psychiatrist:
(1) risk of self-harm or suicide (based on thoughts, plans or acts)
(2) psychosis
(3) history of postpartum psychosis
(4) history of schizophrenia
(5) history of bipolar disorder
(6) history of mania or hypomania
(7) severe depression, current or recent
(8) inadequate response to psychotherapy or pharmacotherapy
(9) severe comorbid psychiatric disorder (substance abuse, eating disorder, panic disorder, anxiety disorder, obsessive-compulsive disorder)
Additional reasons might include:
(1) incapacitated by the depression and unable to function