Obsessive-Compulsive Disorder in Primary Care: Overview on Diagnosis and Management

Background: Obsessive-Compulsive Disorder (OCD) is a debilitating condition marked by the presence of intrusive obsessions and repetitive compulsions. The primary care setting often serves as the first line of contact for individuals grappling with mental health issues, making it a crucial frontier in the early detection and management of OCD. Therefore, the accurate diagnosis of OCD in such settings is essential for effective management. Objective: This review article aims to provide a comprehensive overview of the diagnostic process for OCD, emphasizing the clinical presentation, differential diagnosis, and various diagnostic tools available. Additionally, it explores current strategies for managing OCD, including pharmacological and psychotherapeutic interventions. Methodology: For this review, a comprehensive literature search was conducted using Google Scholar and PubMed databases. Keywords such as "Diagnosis," "obsessive compulsive disorder," and "management" were employed to narrow down relevant studies. Both qualitative and quantitative research papers were included, while non-English publications and those lacking peer-review were excluded. Results: Core symptoms of OCD include obsessions and compulsions, with the Y-BOCS being a standard measure for diagnosis. Differential diagnosis is essential to distinguish OCD from other conditions. SSRIs have been recognized as first-line pharmacological treatments. CBT, particularly Exposure and Response Prevention, remains a potent psychotherapeutic intervention. Emerging treatments like DBS and TMS offer hope for those unresponsive to conventional treatments. Combination therapies have shown enhanced efficacy in certain cases. Conclusion: The meticulous diagnosis of OCD requires recognizing its core symptoms, ruling out other conditions, and leveraging validated clinical tools. A multi-faceted management approach combining pharmacological and psychological treatments ensures optimal patient outcomes, with ongoing research introducing promising new interventions

OVERVIEW ON ROLE OF PRIMARY CARE IN MANAGEMENT OF CHRONIC KIDNEY DISEASE

Chronic kidney disease (CKD) is characterised by the presence of kidney damage or an estimated glomerular filtration rate (eGFR). Patients with more advanced stage 3 or stage 4 CKD experience a higher incidence of cardiovascular events and mortality. Because chronic kidney disease is a growing health concern, family physicians must be equipped to care for this unique patient population. Practice recommendations encourage proactive care of cardiovascular risk, the side effects of metabolic bone disease, and anaemia in these individuals as well as surveillance for increasing kidney disease. Primary care physicians (PCPs) are on the front lines of identifying and treating CKD as early as possible. However, the majority of PCPs frequently miss the existence of CKD. Additionally, the majority of patients with stages 3 and 4 CKD are not co-managed by nephrologists, despite the fact that increasing nephrologists' engagement in the care of these patients has been associated with improved dialysis-free survival. Early detection and treatment of these issues can stop the onset of subsequent sequelae, thus they shouldn't wait till nephrology is involved. This patient population also need appropriate counselling and health maintenance, both of which should be provided by the family doctor overseeing the patient's care