Is the result a diagnosis?

No. The GAD-7 shows how strongly anxiety symptoms have affected the patient recently. Only a doctor or psychotherapist can make a diagnosis after a full assessment.

What does a score of 10 or more mean?

10 points is the developers' cutoff for a closer assessment. It does not mean that an anxiety disorder is definitely present.

Why does it ask about the last two weeks?

Two weeks is long enough to show a pattern, but short enough to reflect how the patient is doing right now. This also makes it possible to repeat the questionnaire and compare results over time.

Can it be filled in more than once?

Yes. Repeating the GAD-7 every few weeks can help you notice whether the patient's symptoms are getting better or worse.

Can alcohol or drugs affect the result?

Yes. Substance use and withdrawal can both cause or increase anxiety symptoms. If this applies to the patient, it is worth noting when the result is discussed with a professional.

Are the responses stored?

No. The responses are processed only in your browser and are not sent or saved anywhere.

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GAD-7

Generalized Anxiety Disorder-7

A short questionnaire that measures how strongly anxiety symptoms have affected the patient over the last two weeks.

Category: Anxiety
Who fills it in: Self-report
Items: 7
Recall period: Last 2 weeks

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Administer the scale

0 of 7 completed

Record the patient's response to every item. Entries stay in your browser and are never sent anywhere.

Over the last 2 weeks, how often have you been bothered by the following problems?

1. Feeling nervous, anxious or on edge
Feeling nervous, anxious or on edge
Not at allSeveral daysMore than half the daysNearly every day

Question 1 of 7

What it measures

The GAD-7 measures how severe anxiety symptoms are. Each of the seven questions is scored from 0 to 3, giving a total between 0 and 21. It was developed for generalised anxiety disorder, but also gives a first indication of panic disorder, social anxiety disorder and post-traumatic stress disorder.

When to use it

Use the GAD-7 when a patient often feels nervous, tense or worried and you want to understand how strongly this affects them. Anxiety is common alongside alcohol or drug use, for example when substances are used to calm down, or when anxiety increases during withdrawal. The GAD-7 can also be repeated over time to see whether symptoms change, for example during treatment. Clinicians use it as a quick screen and to monitor symptom severity.

Origin

The GAD-7 was developed by Dr. Robert L. Spitzer, Dr. Janet B.W. Williams, Dr. Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc., and published in 2006. It belongs to the same family of questionnaires as the PHQ-9 for depression and uses a similar answer format.

Validation

The GAD-7 was validated in 2,740 primary care patients in the United States. Follow-up research showed good sensitivity and specificity not only for generalised anxiety disorder but also for panic, social anxiety and post-traumatic stress disorder. The German version was validated and standardised in a large sample of the German general population (Löwe et al., 2008), which provides German reference values.

Limitations

The GAD-7 is a screening questionnaire, not a diagnosis. A high score shows that anxiety symptoms are present, but not which anxiety disorder – if any – lies behind them; that requires a clinical assessment. Symptoms can also have physical causes or be caused by medication or substances, including withdrawal. The questionnaire only covers the last two weeks and relies on self-report. Because different anxiety disorders vary a lot, a single short questionnaire may not capture every type of anxiety equally well.

Frequently asked questions

Is the result a diagnosis?: No. The GAD-7 shows how strongly anxiety symptoms have affected the patient recently. Only a doctor or psychotherapist can make a diagnosis after a full assessment.
What does a score of 10 or more mean?: 10 points is the developers' cutoff for a closer assessment. It does not mean that an anxiety disorder is definitely present.
Why does it ask about the last two weeks?: Two weeks is long enough to show a pattern, but short enough to reflect how the patient is doing right now. This also makes it possible to repeat the questionnaire and compare results over time.
Can it be filled in more than once?: Yes. Repeating the GAD-7 every few weeks can help you notice whether the patient's symptoms are getting better or worse.
Can alcohol or drugs affect the result?: Yes. Substance use and withdrawal can both cause or increase anxiety symptoms. If this applies to the patient, it is worth noting when the result is discussed with a professional.
Are the responses stored?: No. The responses are processed only in your browser and are not sent or saved anywhere.

References

Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092-1097.
Kroenke K, Spitzer RL, Williams JBW, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317-325.
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):266-274.
Kroenke K, Spitzer RL, Williams JBW, Löwe B. The Patient Health Questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32:345-359.
Instructions for Patient Health Questionnaire (PHQ) and GAD-7 Measures. Instruction manual, www.phqscreeners.com.

Licence & attribution

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.

Public domain.