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WASHINGTON — Doctors at Walter Reed Army Medical Center are treating fewer torso and limb injuries in troops returning from combat but more brain trauma and psychological disorders, the top Pentagon health official said Wednesday.

Ward Casscells, assistant secretary of defense for health affairs, said that’s largely due to the drop in violence in Iraq, and could reverse as fighting intensifies in Afghanistan in coming months.

But he also credited better recognition of brain injuries by doctors and a lessening of the stigma associated with some psychological diagnoses. For example, physicians saw an increase in the number of patients reporting symptoms of depression over the last year.

"Guys are telling us they would still much rather be diagnosed with traumatic brain injury than post-traumatic stress disorder," Casscells said. "But we’re getting at some of that stigma. We’ve reduced it a bit.

"And as we increase dwell time, we hope to see decreases in those numbers as well."

More than 80 percent of "wounded warrior" patients at Walter Reed are dealing with traumatic brain injuries, post-traumatic stress disorder, concussion complications and similar wounds, hospital officials said.

On Tuesday, Casscells and other military health experts toured the facility to see changes made in the two years since a Washington Post investigative report found poor living conditions and frustrating regulations for some patients.

Commander Col. Norvell V. Coots touted improvements in communication with patients and living quarters but acknowledged that more than half of patients still complain about difficulties getting timely appointments with their doctors.

"In the civilian sector you have your doctor … but when you call here, Dr. Jones may be in Iraq or Afghanistan or assigned somewhere else," he said. "So we’re trying to get to a team approach to help address that.

"But they want to make an appointment quickly, and we need to do better to help with that."

Coots said Walter Reed officials are also surveying patients regularly to better gauge their complaints and will have front-desk "greeters" on call around the clock starting next month to provide more access to help for troops and their families.

Casscells said he’s pleased with the improvements thus far, noting that the most of the feedback he receives from patients now during regular visits focuses on improving family housing on campus.

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