Measure severity of anxiety
Audience: PRACTITIONER
Published by EVAL Foundation
Revision 2 · Published August 1, 2024
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:
Lifestyles recommendations that may reduce anxiety-related symptoms include:
Therapeutic modalities that may reduce anxiety-related symptoms include:
.
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?
Current: Revision 2
About this evaluation