Generalized Anxiety Disorder 7 Item Scale (GAD-7)

The Generalized Anxiety Disorder - 7 Item Scale (GAD-7) is a self-administered questionnaire designed for screening and measuring the severity of generalized anxiety disorder (GAD). Developed by Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues, the scale has gained widespread acceptance in both clinical and research settings for its efficiency and accuracy in assessing GAD symptoms. The GAD-7 consists of seven items that respondents rate based on their experiences over the past two weeks, with each item scored from 0 (not at all) to 3 (nearly every day). The cumulative score, ranging from 0 to 21, indicates the severity of GAD symptoms, with higher scores corresponding to greater anxiety levels. This simplicity in administration and interpretation makes the GAD-7 a practical tool for healthcare providers to quickly assess anxiety levels and monitor changes over time.

The development of the GAD-7 was motivated by the need for a reliable, valid, and efficient tool for identifying probable cases of GAD and assessing symptom severity. Prior to the introduction of the GAD-7, the diagnosis and assessment of generalized anxiety disorder often required more time-intensive methods, such as structured clinical interviews. The creation of the GAD-7 involved rigorous empirical research, including psychometric analyses to ensure the scale's validity and reliability. It was validated against structured psychiatric interviews, which are considered the gold standard for diagnosing GAD. This process established the GAD-7 as an effective screening tool that could be easily integrated into clinical practice, allowing for the rapid identification of individuals in need of further psychiatric evaluation or treatment for anxiety.

The GAD-7 has been widely adopted in various healthcare settings due to its strong psychometric properties, including high internal consistency and good test-retest reliability. It has been validated in numerous populations and has shown to be effective in diverse demographic and clinical groups. Beyond its use in screening for GAD, the GAD-7 scores have been found to correlate with functional impairment, disability, and quality of life measures, providing a broader view of how anxiety affects individuals' daily lives. Its application extends beyond primary care and psychiatric clinics to research studies exploring the epidemiology of GAD, the effectiveness of interventions, and the relationship between anxiety and other health conditions. The GAD-7 thus plays a crucial role in the early detection of anxiety disorders, facilitating timely intervention and contributing to the broader understanding of anxiety's impact on health and well-being.

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

  Not At All Several Days Over Half The Days Nearly Everyday
1. Feeling nervous, anxious, or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5. Being so restless that it’s hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid as if something awful might happen
  1. RL Spitzer et all. A Brief Measure for Assessing Generalized Anxiety Disorder. 166(10) Arch Intern Med 1092-1097. .
  2. RP Swinson. The GAD-7 Scale was Accurate for Diagnosing Generalised Anxiety Disorder. 11(6) Evid Based Med 184. .