A 14-year-old boy shows symptoms indicating potential depression. What is the most critical information the physician should obtain?

In assessing a potential case of depression in a 14-year-old boy, determining suicidal ideation or attempts is the most critical information for the physician to obtain. This is because suicidal thoughts and behaviors are serious manifestations of depression and can indicate a higher risk of self-harm or suicide, which are urgent concerns that require immediate attention.

Understanding whether the patient has experienced thoughts of suicide or attempted suicide not only helps to assess the severity of the depressive symptoms but also guides immediate safety planning and intervention strategies. Clinicians prioritize this information to evaluate the risk of harm and to initiate appropriate treatment or referrals as needed.

While other factors such as developmental history, family history of affective disorders, and school history are important for forming a comprehensive understanding of the patient's background and overall situation, they do not address the immediate risk of suicide. Gathering this critical information about suicidality is essential for ensuring the adolescent's safety and determining the urgency of the clinical response.