OET Writing practice · Medicine
Suspected bipolar disorder after SSRI – psychiatrist
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
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Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 10/09/2026 You are a GP at Northgate Surgery, 71 College Road, Linfield. Patient: Ms Chloé Dubois, DOB 17/04/2000 (26 yrs) Social background: - PhD student (chemistry); part-time teaching assistant at university - Lives with partner (Tom, 28) in rented flat - Non-smoker. Alcohol previously approx. 6 units/week; approx. 25 units/week over past month - Cannabis occasionally at weekends - Parents live in Lyon, France; close to mother Family history: - Father: "manic depression", on lithium for many years - Paternal uncle: died by suicide, age 35 Medical history: - Depressive episode (2024): sertraline 50 → 100 mg; recovered, weaned off 01/2025 - Glandular fever (2018) - Acne (teenage years), resolved - Contraception: desogestrel 75 mcg daily - NKDA Consultation notes: 08/07/2026 - Low mood × 6 weeks, early morning waking, loss of interest, poor concentration. PHQ-9: 17 - No suicidal ideation. Protective factors: partner, family, PhD - Sertraline 50 mg daily restarted. Referred to talking therapies (waiting list approx. 10 weeks) 05/08/2026 - Mood "much better". PHQ-9: 8. Sleeping 7 hrs - Continue sertraline 50 mg 09/09/2026 (attends with partner) - Partner reports 2 weeks of: sleeping 3–4 hrs/night without tiredness, talking rapidly, starting many projects, plans to leave PhD to launch "a global app" - Spent approx. £3,500 on credit card (equipment, flights) - Irritable; argument with PhD supervisor. Driving fast - Pt feels "better than ever"; reluctant to accept anything is wrong but agrees to see a specialist - MSE: well kempt, brightly dressed. Pressured speech, flight of ideas. Mood elated. Grandiose ideas (app will "end world hunger"). No hallucinations or persecutory ideas. Denies thoughts of suicide or self-harm. Insight partial - Risk: financial, driving, alcohol. No risk to others identified - Bloods: TFT, FBC normal. Urine drug screen: cannabis positive - Cold sore on lip → aciclovir cream 10/09/2026 (telephone, partner with pt consent) - Slept 4 hrs. Pt agreed to stop sertraline yesterday - Partner now holding pt's credit cards (pt agreed) Assessment: - Probable hypomanic episode, possibly triggered by antidepressant; suspected bipolar affective disorder Plan: - Sertraline stopped - Promethazine 25 mg nocte PRN for sleep (7 days) - Urgent referral to community mental health team psychiatrist (within 1 week) - Advised to avoid alcohol and cannabis and not to drive - Crisis team number given to pt and partner - GP review 14/09/2026 Writing Task: Using the information in the case notes, write a letter to Dr Imran Siddiqui, Consultant Psychiatrist, Linfield Community Mental Health Team, Brook House, 5 Weaver Street, Linfield, referring Ms Dubois for urgent assessment. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.