30 year old professional gentleman presenting with progressive behavioral disinhibition and dysexecutive cognitive syndrome leading to termination of employment. Mental state examination revealed a cheerful, unconcerned and overfamiliar gentleman who was moderately restless and giggled during interview. His mood was elevated and affect expansive. Speech was generally coherent, but rapid, distractible and prone to abrupt changes of subject. Content was positive and excited, focused on past achievements. No evidence of delusions or hallucinations. Well oriented with poor insight and judgment.