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If one or more of the following are present, consider the patient’s condition to be complex:
- Suicidal/homicidal risk 
- Significant and prolonged dysfunction (e.g. WSAS >20)
- Possible bipolar disorder
- Substance abuse
- Psychosis
- Personality disorder
- Borderline personality screener (seven or more positive answers is a positive screen)
- ADHD
- Elderly
- Diagnostic uncertainty
- Refractory to treatment