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This case study describes an older adult war veteran who served during World War II (WWII) and later developed disruptive behaviors related to psychosomatic symptoms, dementia, and his war-related fear of dying. While in the service, he developed lifelong gastrointestinal problems and was subsequently diagnosed with undifferentiated somatization disorder (USD). USD is a mental illness characterized by medically unexplained physical symptoms originating from psychological or emotional distress. The geropsychology team who worked with the veteran postulated the association of WWII experiences to his somatic symptoms; however, this veteran never received treatment for posttraumatic stress disorder (PTSD), and only a couple of notes in his computerized medical record referenced his wartime experiences. A stepwise approach to care was necessitated to identify a successful, individualized treatment. Phase I of treatment was aimed to reduce attachment anxiety and related behavioral disturbances when the veteran moved into the nursing home. In Phase II, cognitive behavioral therapy and acceptance and commitment therapy were used to help the veteran cope with somatic symptoms. In Phase III, Montessori-based interventions were used to minimize distress associated with dementia-related cognitive impairment and associated war-related somatization and fear of dying. We contemplate the possibility that the veteran’s presentation is a variant of PTSD that has not been described in the literature. We hope that you find this case study to be not the story of someone enduring a life of chronic mental and physical illnesses, but instead our discoveries about the man who persevered with courage and dignity.

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An 8-week, randomized, phase 2, double-blind, sequential parallel-group comparison study of two dose levels of the GABA A positive allosteric modulator PF-06372865 compared with placebo as an adjunctive treatment in outpatients with inadequate response to standard of care for generalized anxiety disorder.