GAD-7

Why use it

Brief, validated screening tool for generalized anxiety. Monitors treatment response over time. Widely used in primary care and mental health. Recommended by multiple clinical guidelines.

About

The GAD-7 is a validated self-report questionnaire used to screen for and measure the severity of generalized anxiety disorder. It assesses seven symptoms over the past 2 weeks, scoring 0-3 for each. It is commonly used alongside the PHQ-9 for depression screening in primary care and mental health settings.

When to use

• Screening for generalized anxiety disorder in primary care
• Baseline assessment before initiating anxiolytic therapy
• Monitoring treatment response (repeat every 2-4 weeks)
• Research and epidemiological studies

Formula

Pearls & pitfalls

• GAD-7 ≥ 10 has a sensitivity of 89% and specificity of 82% for GAD.
• Also screens reasonably well for panic disorder, social anxiety, and PTSD.
• Use alongside PHQ-9 — anxiety and depression are highly comorbid.
• A 5-point change is considered clinically significant for treatment monitoring.
• Item 10 (difficulty question) assesses functional impairment but is not part of the total score.
• Patient self-report — quick to administer (< 2 minutes).

Next steps

Score ≥ 10: Probable GAD — consider clinical interview for formal diagnosis. Score ≥ 15: Severe anxiety — refer to mental health specialist. All positive screens should include assessment of functional impairment and safety.

Evidence

Developed and validated by Spitzer et al. (Arch Intern Med, 2006) in 2,740 primary care patients. Internal consistency α = 0.92. Test-retest reliability ICC = 0.83. Validated in multiple languages and populations.

References

1. Spitzer RL et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097. — link