GAD-7

Screens for and monitors severity of generalized anxiety disorder

Indication

Screens for and monitors severity of generalized anxiety disorder

Criteria

id: nervous; label: Feeling nervous, anxious, or on edge; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: uncontrollable; label: Not being able to stop or control worrying; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: excessive; label: Worrying too much about different things; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: relaxing; label: Trouble relaxing; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: restless; label: Being so restless that it is hard to sit still; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: irritable; label: Becoming easily annoyed or irritable; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3
id: afraid; label: Feeling afraid, as if something awful might happen; type: options; options: label: Not at all; value: 0; label: Several days; value: 1; label: More than half the days; value: 2; label: Nearly every day; value: 3

Interpretation

function(score) { if (score <= 4) return { risk: score + '/21', tier: 'Minimal Anxiety', action: 'Monitor. No treatment indicated.', color: 'green' }; if (score <= 9) return { risk: score + '/21', tier: 'Mild Anxiety', action: 'Watchful waiting; reassess. Consider counseling.', color: 'green' }; if (score <= 14) return { risk: score + '/21', tier: 'Moderate Anxiety', action: 'Consider pharmacotherapy (SSRI/SNRI) and/or CBT.', color: 'yellow' }; return { risk: score + '/21', tier: 'Severe Anxiety', action: 'Active treatment warranted. Pharmacotherapy + psychotherapy. Consider psychiatry referral.', color: 'red' }; }

Clinical pearls

GAD-7 ≥10 has 89% sensitivity and 82% specificity for GAD
Also screens for panic disorder, social anxiety, and PTSD (though specific tools are better)
GAD-2 (first 2 items) can be used as initial screen; if ≥3, administer full GAD-7

Source and review

Spitzer et al., Arch Intern Med 2006. Last reviewed: 2024-11-01