|
Level of Psychomotor Activity
| 29)
Was there evidence of: |
| a)
Restlessness (e.g. Gets in and out of bed) |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 35 |
| b)
Tremors |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 36 |
| c)
Grasping/picking |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 37 |
| d)
Increased speed of motor response (e.g. Grabs for a glass suddenly) |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 38 |
| e)
Wandering |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 39 |
| f)
Lethargy and sluggishness |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 40 |
| g)
Slowness of motor response |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 41 |
| h)
Staring into space |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | _____ |
| | | | 42 |
| 30)
(if any of the above, i.e. 29a-29h, are present) Did the psychomotor
activity fluctuate during the interview, for example, patient was
first sluggish and then began moving very quickly? |
| 1 No | 2 Mild | 3 Moderate | 4 Severe | 7 Not
Applicable | _____ |
| | | | | 43 |
| a)
During the interview was the patient poneyed, mittened, or
otherwise restrained? |
| 1 No | 2 Yes | 7 Not
Applicable | | | _____ |
| | | | | 44 |
|
Notes on behavior:
Level
of Psychomotor Activity Score _____
45
1=
Not Present
2= Present
Present: Items 29 a-h
|