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A 10-year-old boy is seen in a paediatric outpatient clinic. Over six months he has become irritable, has stopped playing soccer, which he loved, and takes over an hour to fall asleep. His father died two years ago. His mother reports that he has twice said he wishes he was dead, and that last week he told a school friend he would swallow her blood pressure tablets, which sit in an unlocked kitchen drawer. He wets the bed on about three nights each week. Which one of the following features most strongly indicates that he needs a mental health assessment today rather than routine review?
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