GAD-7 Global Anxiety

Standardized Assessment Tool to Measure Anxiety Outcomes

Included FREE with the KipuEMR.

Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD). GAD-7 has seven items, which measure the severity of various signs of GAD according to reported response categories with assigned points.

GAD-7 is a sensitive, self-administered test to assess generalized anxiety disorder, typically used in outpatient and primary care settings for referral to a psychiatrist, pending outcome. However, it cannot be used as a replacement for clinical assessment, and additional evaluation should be used to confirm a diagnosis of GAD.

The scale uses a normative system of scoring with a question at the end qualitatively describing the severity of the patient’s anxiety over the previous two weeks.

A seven-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale.

When to Use the GAD Survey

The GAD-7 is a useful and efficient tool for screening for GAD and assessing its severity in clinical practice and research. One of the most common anxiety disorders seen in general medical practice and the general population is generalized anxiety disorder (GAD). The condition has an estimated current prevalence in general medical practice of 2.8% to 8.5% and in the general population of 1.6% to 5.0%. Whereas depression in clinical settings has generated substantial research, there have been far fewer studies of anxiety. In part, this may be because of the paucity of brief validated measures for anxiety compared with the numerous measures for depression, such as the Primary Care Evaluation of Mental Disorders 9-item Patient Health Questionnaire (PHQ-9). This situation is unfortunate, given the high prevalence of anxiety disorders, as well as their associated disability and the availability of effective treatments, both pharmacological and non-pharmacological.

Measures of anxiety are seldom used in clinical practice because of their length, proprietary nature, lack of usefulness as a diagnostic and severity measure, and requirement of clinician administration rather than patient self-report. The goal of this study was to develop a brief scale to identify probable cases of GAD and to assess symptom severity. We conducted a study in multiple primary care sites to select the items for the final scale and to evaluate its reliability and validity.

Sample GAD Survey

Are you bothered by at least three of the following?

Are you bothered by at least three of the following?

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate anxiety disorders.

More days than not, do you feel

During the last year, has the use of alcohol or drugs…