General Anxiety Disorder (GAD-7)
Measure severity of anxiety
Créateur
Dr. Robert L. Spitzer, MDInstructions
The GAD-7 is a screening tool used by health practitioners to determine initial symptom severity and monitor effect of treatment over time and does not replace a clinical assessment and diagnosis.
Ask: How often have you been bothered by the following over the past 2 weeks?
Introduction
Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States (Locke, Kirst & Shultz, 2015). The Generalized Anxiety Disorder-7 (GAD-7) is a validated diagnostic tool and a symptom severity assessment scale that assists clinicians, typically primary care and mental health settings, with rapid screening for the presence of a clinically significant anxiety disorder, such as GAD, PD, social phobia (SP) & post-traumatic stress disorder (PTSD). GAD-7 can objectively determine initial symptom severity and monitor symptom changes and the effect of treatment over time. Studies suggest 70-90% sensitivity and 80-90% specificity across anxiety disorders. Higher GAD-7 scores correlate with disability and functional impairment in measures to include work productivity and health care utilization (Spitzer, 2006 & Ruiz, 2011). The scale was originally developed and validated based on the DSM-IV criteria. However, since the publication of the DSM-V criteria, the scale remains clinically useful because the differences in GAD diagnostic criteria are minimal.
The Generalized Anxiety Disorder-7 (GAD-7) is a validated diagnostic tool and a symptom severity assessment scale that assists clinicians, typically primary care and mental health settings, with rapid screening for the presence of a clinically significant anxiety disorder, such as GAD, PD, social phobia (SP) & post-traumatic stress disorder (PTSD). GAD-7 is a 7-question assessment. A range of 0-3 points are assigned to each answer. The 8th question assesses global impairment and is not counted in the score (max score of 21 points).
Scoring & Recommendations
The first 7 questions will answer with one of the following:
Answer | Points |
Not at all | 0 |
Several days | 1 |
More than half the days | 2 |
Nearly every day | 3 |
Result | Recommendation | Score |
No anxiety disorder | N/A | < 5 points |
Mild anxiety disorder | Monitor | 5-9 points |
Studies suggest a score ≥ 8 in suspected Panic Disorder, Social Phobia or PTSD may be a moderate anxiety disorder | Need for further evaluation and referral for possible clinically significant condition. | 8-9 points |
Moderate anxiety disorder | Need for further evaluation and referral for possible clinically significant condition. | 10-14 points |
Severe anxiety disorder | Need for further evaluation and referral for possible clinically significant condition. Active treatment is likely warranted. | > 15 points |
Additional Considerations
The PRO-MIS Emotional Distress - Anxiety - Short Form for Adults and the Severity Measure for Generalized Anxiety Disorder - Adult can aid clinical evaluation of generalized anxiety disorders and monitor treatment effectiveness.
The Severity Measure for Panic Disorder - Adult is an assessment scale that can complement the clinical assessment of patients with panic disorder.
In a suspected anxiety disorder, medical conditions with similar presentations ought to be excluded, such as:
Endocrine conditions: Hyperthyroidism, pheochromocytoma, hyperparathyroidism
Cardiopulmonary conditions: Arrhythmia, obstructive pulmonary diseases
Neurologic diseases: Temporal lobe epilepsy, TIA
Other psychiatric disorders: Major depressive disorder, bipolar disorder, other anxiety disorders
Substance abuse withdrawal
Medications: Common ones include albuterol, levothyroxine, decongestants
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Identifying and removing possible triggers
Caffeine: Consider increase sensitivity to caffeine (slow metabolizer) due to genetic polymorphisms in adenosine receptors.
Stimulants: Can include medications, supplements or caffeine products ingested in the evening.
Nicotine
Dietary triggers: Consider mold sensitivity from food or the environment. Foods such as coffee, peanuts and grains can have high levels of mold. Many other food sensitivities or allergies can also play a role. A food journal and an elimination diet may help sort this out.
Stress
Improving sleep quality and quantity
Physical activity
Therapeutic modalities that may reduce anxiety-related symptoms include:
Psychotherapy
Cognitive behavioral therapy
Relaxation therapies
Meditation
Mindfulness-based stress reduction and breathing techniques
Complementary and alternative medicine
Botanicals and supplements (See table 6)
Massage
Sound therapy
Aromatherapy
Toutes les questions et résultats possibles
InstructionsTitre non visible
Feeling nervous, anxious, or on edge
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly every day
Not being able to stop or control worrying
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly every day
Worrying too much about different things
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly everyday
Trouble relaxing
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly everyday
Being so restless that it's hard to sit still
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly every day
Becoming easily annoyed or irritable
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly every day
Feeling afraid as if something awful might happen
Select one option:
- Not at all
- Several days
- More than half the days
- Nearly every day
How difficult have these problems made it to do work, take care of things at home, or get along with other people?
Optional: Not included in the final score. Helps to assess global impairment.
Select one option:
- Not at all
- Somewhat difficult (Several days)
- Very difficult (More than half the days)
- Extremely difficult (Nearly every day)
Résultats possibles
Studies suggest a score ≥ 8 in suspected Panic Disorder, Social Phobia or PTSD may be a moderate anxiety disorder
In suspected Panic Disorder, Social Phobia or PTSD, a ≥ 8 indicates a need for further evaluation for a possible clinically significant condition.
The Severity Measure for Panic Disorder - Adult is an assessment scale that can complement the clinical assessment of patients with panic disorder.
The PRO-MIS Emotional Distress - Anxiety - Short Form for Adults and the Severity Measure for Generalized Anxiety Disorder - Adult can aid clinical evaluation of generalized anxiety disorders and monitor treatment effectiveness.
In a suspected anxiety disorder, medical conditions with similar presentations ought to be excluded, such as:
Endocrine conditions: Hyperthyroidism, pheochromocytoma, hyperparathyroidism
Cardiopulmonary conditions: Arrhythmia, obstructive pulmonary diseases
Neurologic diseases: Temporal lobe epilepsy, TIA
Other psychiatric disorders: Major depressive disorder, bipolar disorder, other anxiety disorders
Substance abuse withdrawal
Medications: Common ones include albuterol, levothyroxine, decongestants
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Identifying and removing possible triggers
Caffeine: Consider increase sensitivity to caffeine (slow metabolizer) due to genetic polymorphisms in adenosine receptors.
Stimulants: Can include medications, supplements or caffeine products ingested in the evening.
Nicotine
Dietary triggers: Consider mold sensitivity from food or the environment. Foods such as coffee, peanuts and grains can have high levels of mold. Many other food sensitivities or allergies can also play a role. A food journal and an elimination diet may help sort this out.
Stress
Improving sleep quality and quantity
Physical activity
Therapeutic modalities that may reduce anxiety-related symptoms include:
Psychotherapy
Cognitive behavioral therapy
Relaxation therapies
Meditation
Mindfulness-based stress reduction and breathing techniques
Complementary and alternative medicine
Botanicals and supplements (See table 6)
Massage
Sound therapy
Aromatherapy
Mild anxiety disorder (5-9 points)
In a suspected anxiety disorder, medical conditions with similar presentations ought to be excluded, such as:
Endocrine conditions: Hyperthyroidism, pheochromocytoma, hyperparathyroidism
Cardiopulmonary conditions: Arrhythmia, obstructive pulmonary diseases
Neurologic diseases: Temporal lobe epilepsy, TIA
Other psychiatric disorders: Major depressive disorder, bipolar disorder, other anxiety disorders
Substance abuse withdrawal
Medications: Common ones include albuterol, levothyroxine, decongestants
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Identifying and removing possible triggers
Caffeine: Consider increase sensitivity to caffeine (slow metabolizer) due to genetic polymorphisms in adenosine receptors.
Stimulants: Can include medications, supplements or caffeine products ingested in the evening.
Nicotine
Dietary triggers: Consider mold sensitivity from food or the environment. Foods such as coffee, peanuts and grains can have high levels of mold. Many other food sensitivities or allergies can also play a role. A food journal and an elimination diet may help sort this out.
Stress
Improving sleep quality and quantity
Physical activity
Therapeutic modalities that may reduce anxiety-related symptoms include:
Psychotherapy
Cognitive behavioral therapy
Relaxation therapies
Meditation
Mindfulness-based stress reduction and breathing techniques
Complementary and alternative medicine
Botanicals and supplements (See table 6)
Massage
Sound therapy
Aromatherapy
Severe anxiety disorder (> 15 points)
When screening for anxiety disorders, a score > 15 indicates a need for further evaluation and referral for possible clinically significant condition. Active treatment is likely warranted.
The PRO-MIS Emotional Distress - Anxiety - Short Form for Adults and the Severity Measure for Generalized Anxiety Disorder - Adult can aid clinical evaluation of generalized anxiety disorders and monitor treatment effectiveness.
The Severity Measure for Panic Disorder - Adult is an assessment scale that can complement the clinical assessment of patients with panic disorder.
In a suspected anxiety disorder, medical conditions with similar presentations ought to be excluded, such as:
Endocrine conditions: Hyperthyroidism, pheochromocytoma, hyperparathyroidism
Cardiopulmonary conditions: Arrhythmia, obstructive pulmonary diseases
Neurologic diseases: Temporal lobe epilepsy, TIA
Other psychiatric disorders: Major depressive disorder, bipolar disorder, other anxiety disorders
Substance abuse withdrawal
Medications: Common ones include albuterol, levothyroxine, decongestants
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Identifying and removing possible triggers
Caffeine: Consider increase sensitivity to caffeine (slow metabolizer) due to genetic polymorphisms in adenosine receptors.
Stimulants: Can include medications, supplements or caffeine products ingested in the evening.
Nicotine
Dietary triggers: Consider mold sensitivity from food or the environment. Foods such as coffee, peanuts and grains can have high levels of mold. Many other food sensitivities or allergies can also play a role. A food journal and an elimination diet may help sort this out.
Stress
Improving sleep quality and quantity
Physical activity
Therapeutic modalities that may reduce anxiety-related symptoms include:
Psychotherapy
Cognitive behavioral therapy
Relaxation therapies
Meditation
Mindfulness-based stress reduction and breathing techniques
Complementary and alternative medicine
Botanicals and supplements (See table 6)
Massage
Sound therapy
Aromatherapy
Moderate anxiety disorder (10-14 points)
When screening for anxiety disorders, a score > 9 indicates a need for further evaluation and referral for possible clinically significant condition.
The PRO-MIS Emotional Distress - Anxiety - Short Form for Adults and the Severity Measure for Generalized Anxiety Disorder - Adult can aid clinical evaluation of generalized anxiety disorders and monitor treatment effectiveness.
The Severity Measure for Panic Disorder - Adult is an assessment scale that can complement the clinical assessment of patients with panic disorder.
In a suspected anxiety disorder, medical conditions with similar presentations ought to be excluded, such as:
Endocrine conditions: Hyperthyroidism, pheochromocytoma, hyperparathyroidism
Cardiopulmonary conditions: Arrhythmia, obstructive pulmonary diseases
Neurologic diseases: Temporal lobe epilepsy, TIA
Other psychiatric disorders: Major depressive disorder, bipolar disorder, other anxiety disorders
Substance abuse withdrawal
Medications: Common ones include albuterol, levothyroxine, decongestants
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Identifying and removing possible triggers
Caffeine: Consider increase sensitivity to caffeine (slow metabolizer) due to genetic polymorphisms in adenosine receptors.
Stimulants: Can include medications, supplements or caffeine products ingested in the evening.
Nicotine
Dietary triggers: Consider mold sensitivity from food or the environment. Foods such as coffee, peanuts and grains can have high levels of mold. Many other food sensitivities or allergies can also play a role. A food journal and an elimination diet may help sort this out.
Stress
Improving sleep quality and quantity
Physical activity
Therapeutic modalities that may reduce anxiety-related symptoms include:
Psychotherapy
Cognitive behavioral therapy
Relaxation therapies
Meditation
Mindfulness-based stress reduction and breathing techniques
Complementary and alternative medicine
Botanicals and supplements (See table 6)
Massage
Sound therapy
Aromatherapy
Citation
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092. PMID: 16717171.
Bibliographie
A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.
https://pubmed.ncbi.nlm.nih.gov/16717171/Validity of the GAD-7 scale as an outcome measure of disability in patients with generalized anxiety disorders in primary care. J Affect Disord. 2011 Feb;128(3):277-86.
https://pubmed.ncbi.nlm.nih.gov/20692043/Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015 May 1;91(9):617-24.
https://pubmed.ncbi.nlm.nih.gov/25955736/
- Créateur
- Fourni par
EVAL Foundation
- Contributeur · Relecteur
Jennifer Glen, DNP, FNP-BCEVAL Health, Chief Medical Officer EVAL Foundation
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