GAD-7 (Generalized Anxiety Disorder 7-item scale) – calculator

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

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

About this calculator

GAD-7 is a screening questionnaire for generalized anxiety disorder and severity assessment. Developed by Spitzer et al. (Arch Intern Med, 2006) in 2740 primary care patients. Seven questions about anxiety symptoms over the past 2 weeks, each scored 0-3. Maximum 21. Interpretation. 0-4 – minimal. 5-9 – mild. 10-14 – moderate (GAD diagnosis threshold, 89% sensitivity, 82% specificity). 15-21 – severe, requires prompt assessment and pharmacotherapy. Clinical use. USPSTF 2023 recommends anxiety screening in all adults up to 65 in primary care. DSM-5 GAD criteria: excessive anxiety and worry >=6 months, difficulty controlling worry, 3+ symptoms (irritability, muscle tension, sleep disturbance, fatigue, concentration problems, restlessness). GAD-7 does not replace clinical interview but raises GAD detection from 30 to 75% in primary care. Treatment. 10+ – discuss therapy: SSRI first line (sertraline 25-200 mg or escitalopram 5-20 mg once daily), SNRI second line (venlafaxine 75-225 mg or duloxetine 30-120 mg). CBT is equivalent to pharmacotherapy in mild-to-moderate anxiety. Severe – combine. Benzodiazepines only for short-term relief during the first weeks of SSRI therapy. Limitations. Screen, not diagnosis. Overlap with depression – pair with PHQ-9. Does not distinguish GAD, panic disorder, social phobia, PTSD – positive results need detailed assessment. In older patients with cognitive decline validation is limited.

Source

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

Formula version: spitzer-2006-v1