Generalized Anxiety Disorder (GAD 7)
Assesses the severity of the most common seven anxious disorder symptoms.
In the text below the calculator you can discover more about the symptoms used and about how the GAD 7 score is interpreted.
This is a mental health assessment that discusses the most common anxiety symptoms in order to provide an overall anxiety severity score. The anxious signs considered are:
1. Feeling nervous, anxious or on edge;
2. Not being able to stop or control worrying;
3. Worrying too much about different things;
4. Trouble relaxing;
5. Being so restless that it is hard to sit still;
6. Becoming easily annoyed or irritable;
7. Feeling afraid as if something awful might happen.
The result provided by the GAD 7 calculator is aimed at revealing whether an anxiety disorder is present and to what degree.
Low scores mean no or little anxiety severity while high scores mean an increased degree of severity.
The following table introduces the scores and their interpretation:
| GAD 7 score (points) | Interpretation |
| 0 - 4 | No or little anxiety |
| 5 - 9 | Mild anxiety disorder |
| 10 - 14 | Moderate anxiety disorder |
| 15 - 21 | Severe anxiety disorder |
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Generalized Anxiety Disorder (GAD 7)
The GAD 7 is a mental health evaluation model aimed at anxiety severity. It takes the form of a questionnaire that is administered to patients in the clinical environment.
The subject is prompted to consider their behaviour in the past two weeks, by taking into account the following:
1. Feeling nervous, anxious or on edge;
2. Not being able to stop or control worrying;
3. Worrying too much about different things;
4. Trouble relaxing;
5. Being so restless that it is hard to sit still;
6. Becoming easily annoyed or irritable;
7. Feeling afraid as if something awful might happen.
Each of the 7 criteria is accompanied by a scale describing the frequency of the anxious sign, as exhibited in the 2 weeks prior to the evaluation:
■ Not at all (0 points) – with the implication that the subject has not experienced the anxious sign in the two week period;
■ Several days (1 point) – the subject has experienced the sign in some days (7 or less);
■ More than half the days (2 points) – the subject has experienced the sign for more than 7 days;
■ Nearly every day (3 points) – with the implication that the sign was experienced almost every day of the two weeks.
GAD 7 scoring interpretation
The result provided by the GAD 7 calculator is aimed at revealing whether an anxiety disorder is present and to what degree.
Each of the 7 questions can be rated from 0 to 3 on the scale introduced above. Therefore, the overall GAD 7 score ranges between 0 and 21, 0 meaning no anxiety and 21 meaning severe anxiety.
The following table introduces the scores along their interpretation and a recommendation:
| GAD 7 score (points) | Interpretation | Recommendation |
| 0 - 4 | No or little anxiety | Common symptoms should continue to be monitored if there are still suspicions. Follow up GAD 7 assessment in 2 weeks. |
| 5 - 9 | Mild anxiety disorder | Patient monitoring needs to be initiated. |
| 10 - 14 | Moderate anxiety disorder | The patient should be evaluated with other quantitative and qualitative measures of psychological/ psychiatric testing. |
| 15 - 21 | Severe anxiety disorder | Treatment needs to be initiated if it hasn’t already. |
About the study
The GAD 7 was created by Spitzer et al. in 2006, as the first clinical measure for assessing the generalized anxiety disorder.
The original study involved a cohort of 2,740 adult patients belonging to 15 primary care clinics in the United States.
Following the application of the questionnaire (within a week), 965 of these patients have been referred for an interview (telephone) with a mental health professional.
The GAD 7 has been validated with independent diagnoses and other measures such as functional status, disability and health care use.
The model has been found to have good reliability and a cut point for optimized sensitivity (89%) and specificity (82%) was found.
Recommended usage
The GAD 7 should be used in association with other anxiety scales, such as the Hamilton scale, especially when there are concerns about the mental health status of the patient.
The application of the questionnaire should be followed by other questions, related to other experiences and symptoms of the patient.
The questionnaire can also be used for anxiety monitoring purposes.
The anxiety screening provided by the GAD 7 scoring can be used in other mental health conditions (the specificity and sensitivity are presented for scores above 10) such as:
■ Generalized Anxiety Disorder – sensitivity 89%, specificity 82%;
■ Panic Disorder – sensitivity 72%, specificity 80%;
■ Post Traumatic Stress Disorder (PTSD) – sensitivity 66%, specificity 81%;
■ Social Phobia – sensitivity 74%, specificity 81%.
Original source
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.
Validation
Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, Herzberg PY. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care. 2008; 46(3):266-74.
Specialty: Psychiatry
System: Nervous
Objective: Evaluation
Type: Calculator
No. Of Items: 7
Year Of Study: 2006
Abbreviation: GAD-7
Article By: Denise Nedea
Published On: March 22, 2017 · 10:50 AM
Last Checked: March 22, 2017
Next Review: March 22, 2023