His general court martial went on about 60 miles south of me, and the crime and trial has gotten extensive media coverage in the Seattle/Tacoma area. His defense attorney, one of the finest criminal defense counsel in the state, was able to negotiate the death penalty off the table. They did not present a medical defense for his actions. Various issues of steroids, TBI, PTSD, liquor and anti-malaria drugs were run up the flagpole earlier and did not get anywhere much. The prosecution pointed out that similar issues came up in several thousand US troops, and none of them went off post twice, making two trips in the dead of night, and slaughtered 16 civilians, dragged their bodies into a heap and set their bodies on fire.
I honestly don't know if there was a medical reason, but he apparently was able to function just fine in life up until that point. He had a previous civil judgement against him for fraud, he was having marital problems and he was pissed that he was passed over for promotion. The sole issue at sentencing was if he would be eligible for parole after serving 20 years or not. The jury decided against it, so he will serve the full sentence.