Validated 7-item screening tool for generalised anxiety disorder.
Source: Spitzer et al., Arch Intern Med 2006.
What does the GAD-7 score mean?
The Generalised Anxiety Disorder 7-item scale (GAD-7) is a validated questionnaire developed by Spitzer and colleagues and published in Archives of Internal Medicine in 2006. It was designed as a brief, self-administered tool that primary care clinicians and researchers can use to screen for generalised anxiety disorder (GAD) and monitor symptom severity.
Each of the 7 questions asks how often you have been bothered by a particular anxiety symptom over the past two weeks, scored 0 (Not at all) to 3 (Nearly every day). Total scores range from 0 to 21. The scale was validated against a structured diagnostic interview (the SCID) in a primary care population, achieving good sensitivity (89%) and specificity (82%) for GAD at a cut-point of 10.
GAD-7 is used not only for generalised anxiety disorder but also as a general anxiety severity measure in studies of social anxiety disorder, panic disorder, and post-traumatic stress disorder. In routine monitoring, a drop of 5 or more points from baseline counts as a clinically meaningful response to treatment.
GAD-7 is a screening tool, not a diagnosis. A high score means you may benefit from a professional assessment. Several other things, including thyroid disease, stimulant use, sleep deprivation, and some heart conditions, can produce symptoms that push the score up.
Reference ranges
| Score | Severity | Suggested action |
|---|---|---|
| 0 – 4 | Minimal anxiety | Monitor; no action usually needed |
| 5 – 9 | Mild anxiety | Self-help strategies; watchful waiting |
| 10 – 14 | Moderate anxiety | Consider professional assessment |
| 15 – 21 | Severe anxiety | Professional assessment recommended |
When should you see a doctor?
If you score 10 or above, or if your anxiety symptoms are significantly affecting your work, relationships, or daily functioning regardless of your score, please speak with your GP, a psychologist, or a mental health professional. Effective treatments for anxiety disorders include cognitive-behavioural therapy (CBT) and, where appropriate, medication. If you are in crisis or having thoughts of harming yourself, contact a crisis service or emergency services immediately.
Frequently asked questions
What GAD-7 score indicates anxiety disorder?
GAD-7 scores are interpreted as: 0–4 = minimal anxiety, 5–9 = mild anxiety, 10–14 = moderate anxiety, 15–21 = severe anxiety. A score of 10 or above has a sensitivity of 89% and specificity of 82% for generalised anxiety disorder (GAD). However, GAD-7 is a screening tool, it cannot diagnose anxiety disorder, which requires clinical assessment.
How does GAD-7 differ from a diagnosis of anxiety?
The GAD-7 is a validated screening questionnaire, a self-report tool that identifies people who may benefit from further evaluation. A formal diagnosis of generalised anxiety disorder (or other anxiety conditions) requires clinical assessment by a qualified mental health professional or physician, who considers symptom duration, functional impairment, rule-out of medical causes, and differential diagnosis.
Is GAD-7 reliable over time?
GAD-7 has good test-retest reliability when administered in the same conditions. It is commonly used to monitor treatment response, a reduction of 5 or more points from baseline is considered a clinically meaningful improvement. The questionnaire covers symptoms over the past 2 weeks, so scores reflect recent state rather than a stable trait.