GAD7

The Generalized Anxiety Disorder 7-item scale (GAD-7) is a seven-item self-report questionnaire designed to screen for generalized anxiety disorder and to assess the severity of generalized anxiety symptoms over the past two weeks. It was developed by Spitzer, Kroenke, Williams, and Löwe and published in 2006.

Each item is rated on a four-point scale from 0 to 3, with response options of not at all, several days, more than half the days, and nearly every day. The total score ranges from 0 to 21. Scores of 5, 10, and 15 represent mild, moderate, and severe anxiety, and a cut-off of 10 is commonly used to indicate likely generalized anxiety disorder. The instrument can also be used to monitor symptom change during treatment.

The GAD-7 is widely used in primary care and mental health settings as a quick screen and to track treatment response. It is not a diagnostic instrument; a positive screen should be followed by a full clinical assessment. The scale has been validated in diverse populations and languages, with high sensitivity and specificity at the ≥10 threshold (approximately 0.88 and 0.82, respectively, in many studies). It may also help identify the presence of other anxiety or mood disorders.

Limitations include potential influence by non-anxiety symptoms such as physical illness, cultural factors, and comorbidity. It may have limited ability to distinguish generalized anxiety disorder from other anxiety disorders (such as panic disorder or social anxiety) or depression.

A shorter version, the GAD-2, uses the first two items of the GAD-7 as a brief initial screen.