Overview
The GAD-7 (Generalized Anxiety Disorder 7-item) Screening Tool implements the validated self-report questionnaire developed by Spitzer, Kroenke, Williams, and Lowe (2006) for screening and measuring the severity of generalized anxiety disorder. This is one of the most widely used anxiety screening instruments in clinical practice, recommended by multiple practice guidelines including NICE and the APA.
Clinical Context
Anxiety disorders are the most prevalent mental health conditions, affecting approximately 18% of adults in the United States. Despite this high prevalence, anxiety disorders are frequently underdiagnosed in primary care settings. The GAD-7 provides a standardized, efficient screening method that can be administered in under 3 minutes and scored instantly.
A score of 10 or greater has a sensitivity of 89% and specificity of 82% for generalized anxiety disorder. The GAD-7 also has good operating characteristics for screening panic disorder, social anxiety disorder, and PTSD (Kroenke et al., 2007).
Features
- Full GAD-7 Scoring: Automated scoring with severity classification (minimal, mild, moderate, severe)
- GAD-2 Brief Screen: Ultra-brief 2-item screening for settings requiring rapid assessment
- Clinical Recommendations: Evidence-based treatment recommendations tailored to severity level, including psychotherapy, pharmacotherapy, and monitoring guidance
- Longitudinal Tracking: Monitor treatment response over time, identifying clinically meaningful improvement (>= 5-point decrease) and remission (score < 5)
- Comorbidity Screening Prompts: Automated reminders to assess for comorbid depression, substance use, and other anxiety disorders
Scoring
Each of the 7 items is rated on a 4-point scale (0 = Not at all, 1 = Several days, 2 = More than half the days, 3 = Nearly every day), yielding a total score of 0-21.
| Score | Severity | Clinical Action |
|---|---|---|
| 0-4 | Minimal | Routine monitoring |
| 5-9 | Mild | Watchful waiting, psychoeducation |
| 10-14 | Moderate | CBT and/or SSRI/SNRI |
| 15-21 | Severe | Combined therapy + medication, consider psychiatry referral |
References
- Spitzer RL, et al. "A Brief Measure for Assessing GAD: The GAD-7." Arch Intern Med. 2006;166(10):1092-1097.
- Kroenke K, et al. "Anxiety Disorders in Primary Care." Ann Intern Med. 2007;146:317-325.
- Plummer F, et al. "Screening for Anxiety Disorders with the GAD-7 and GAD-2." Gen Hosp Psychiatry. 2016;39:24-31.