Generalized Anxiety Disorder 7

Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD).[1] GAD-7 has seven items, which measure severity of various signs of GAD according to reported response categories with assigned points.[2] The GAD-7 items include: 1) nervousness; 2) inability to stop worrying; 3) excessive worry; 4) restlessness; 5) difficulty in relaxing; 6) easy irritation; and 7) fear of something awful happening.[3] Assessment is indicated by the total score, which is made up by adding together the scores for the scale of all seven items.[4] The GAD-7 was originally validated in a primary care sample and a cutoff score of 10 (which the authors considered optimal) had a sensitivity value of 0.89 and a specificity value of 0.82 for identifying GAD. The authors of the questionnaire also found acceptable sensitivity and specificity values when the questionnaire was used as a general screen to identify other anxiety disorders (Panic Disorder, Social Anxiety, and PTSD) (GAD-7, score ≥ 8: sensitivity: 0.77, specificity: 0.82). [5]

GAD-7 is a sensitive self-administrated test to assess generalized anxiety disorder,[6] normally used in outpatient and primary care settings for referral to a psychiatrist pending outcome.[2] The normative data enable users of the GAD-7 to discern whether an individual’s anxiety score is normal, or mildly, moderately, or severely elevated. [7] However, it cannot be used as replacement for clinical assessment and additional evaluation should be used to confirm a diagnosis of GAD.

The scale uses a normative system of scoring as shown below—bullet points of answer options and points assigned—with a question at the end qualitatively describing the severity of the patient's anxiety over the past 2 weeks.[2]

• Not at all (0 points)
• Several days (1 point)
• More than half the days (2 points)
• Nearly every day (3 points)

The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.[8]