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Scoring the GAD-7
Anxiety severity is calculated by assigning scores of 0, 1, 2, and 3 to the categories of 'not at all'; 'several days'; 'more than half the days' and 'nearly every day' respectively. The total score for the seven items ranges from 0 to 21.
Scores of 5, 10, and 15 are cut-off points for mild, moderate, and severe anxiety, respectively
Using the threshold score of 10, the GAD‐7 has a sensitivity of 89% and a specificity of 82% for generalised anxiety disorder (GAD). It is moderately good at screening three other common anxiety disorders - panic disorder (sensitivity 74%, specificity 81%), social anxiety disorder (sensitivity 72%, specificity 80%), and post-traumatic stress disorder (PTSD) (sensitivity 66%, specificity 81%). The sum of the first two questions is sometimes used as a quick guide to the presence of anxiety. The 'GAD-2' as this is called, gives a score between zero and six. A score of three or more warrants further investigation.
When screening for anxiety disorders, a recommended cut-off point for further evaluation is a score of ten or more. A diagnosis can't be made using the GAD-7 alone; a professional clinical interview should consider the possibility of physical causes, drug use and any manic / hypomanic episodes.
Copies of the PHQ and GAD-7 are available from the PHQ Screeners website. From the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ). The GAD-7 was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues. PRIME-MD is a trademark of Pfizer Inc. Copyright 1999 Pfizer Inc. All rights reserved.
Spitzer, R.L., Kroenke, K., Williams, J.B.W., Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine 166 p.1092-1097.
