Full Name Age Mobile No 1. Elevated Mood - Select - Absent (0) Mildly or possibly increased (1) Definite subjective elevation (2) Elevated; inappropriate (3) Euphoric; inappropriate laughter, singing (4) 2. Increased Motor Activity-Energy - Select - Absent (0) Subjectively increased (1) Animated; gestures increased (2) Excessive energy (3) Motor excitement; continuous hyperactivity (4) 3. Sexual Interest - Select - Normal; not increased (0) Mildly increased (1) Definite subjective increase (2) Spontaneous sexual content (3) Overt sexual acts (4) 4. Sleep - Select - No decrease in sleep (0) Sleeping less by up to one hour (1) Sleeping less by more than one hour (2) Decreased need for sleep (3) Denies need for sleep (4) 5. Irritability - Select - Absent (0) Subjectively increased (2) Irritable at times (4) Frequently irritable (6) Hostile, uncooperative (8) 6. Speech (Rate and Amount) - Select - No increase (0) Feels talkative (2) Increased rate at times (4) Push; difficult to interrupt (6) Pressured, continuous speech (8) 7. Language-Thought Disorder - Select - Absent (0) Circumstantial (1) Distractible (2) Flight of ideas (3) Incoherent (4) 8. Content - Select - Normal (0) Questionable plans (2) Special abilities (4) Grandiose ideas (6) Delusions (8) 9. Disruptive-Aggressive Behavior - Select - Absent (0) Sarcastic (2) Demanding (4) Threatening (6) Assaultive (8) 10. Appearance - Select - Appropriate (0) Slightly inappropriate (1) Moderately inappropriate (2) Markedly inappropriate (3) Bizarre (4) 11. Insight - Select - Insight present (0) Possibly ill (1) Admits illness (2) Admits behavior change (3) Denies illness (4) Live Total Score
