Generalized Anxiety Disorder 7

Generalized Anxiety Disorder 7 item
SynonymsGAD-7
LOINC69737-5

Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD).[1] GAD-7 has seven items, which measure severity of various signs of GAD according to reported response categories with assigned points.[2] The GAD-7 items include: 1) nervousness; 2) inability to stop worrying; 3) excessive worry; 4) restlessness; 5) difficulty in relaxing; 6) easy irritation; and 7) fear of something awful happening.[3] Assessment is indicated by the total score, which is made up by adding together the scores for the scale of all seven items.[4] The GAD-7 was originally validated in a primary care sample and a cutoff score of 10 (which the authors considered optimal) had a sensitivity value of 0.89 and a specificity value of 0.82 for identifying GAD. The authors of the questionnaire also found acceptable sensitivity and specificity values when the questionnaire was used as a general screen to identify other anxiety disorders (Panic Disorder, Social Anxiety, and PTSD) (GAD-7, score ≥ 8: sensitivity: 0.77, specificity: 0.82).[5]

GAD-7 is a sensitive self-administrated test to assess generalized anxiety disorder,[6] normally used in outpatient and primary care settings for referral to a psychiatrist pending outcome.[2] The normative data enable users of the GAD-7 to discern whether an individual’s anxiety score is normal, or mildly, moderately, or severely elevated. [7] However, it cannot be used as replacement for clinical assessment and additional evaluation should be used to confirm a diagnosis of GAD.

The scale uses a normative system of scoring as shown below—bullet points of answer options and points assigned—with a question at the end qualitatively describing the severity of the patient's anxiety over the past 2 weeks.[2]

  • Not at all (0 points)
  • Several days (1 point)
  • More than half the days (2 points)
  • Nearly every day (3 points)
Score Risk Level Suggested Intervention
0-4 No to Low risk None
5-9 Mild Repeat on follow-up
10-14 Moderate Further evaluation required. Consider adjusting treatment plan.
15+ Severe Adjust treatment plan. Higher level of care needed. Pharmacology re-evaluation.

Reliability and validity

The use of sumscores (i.e. summing the scores of each item) is supported by psychometric studies, but using techniques based on factor analysis is deemed more precise.[8]

The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.[9]

The GAD-7 showed acceptable psychometric properties in a rural Indian population (ώ-hierarchical = 0.76).[8]

See also

References

  1. ↑ Spitzer RL, Kroenke K, Williams JB, Löwe B (May 2006). "A brief measure for assessing generalized anxiety disorder: the GAD-7". Archives of Internal Medicine. 166 (10): 1092–7. doi:10.1001/archinte.166.10.1092. PMID 16717171.
  2. 1 2 3 Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, Herzberg PY (March 2008). "Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population". Medical Care. 46 (3): 266–74. doi:10.1097/mlr.0b013e318160d093. PMID 18388841. S2CID 16052239.
  3. ↑ Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sánchez SE, Williams MA (2015-04-27). "Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women". PLOS ONE. 10 (4): e0125096. Bibcode:2015PLoSO..1025096Z. doi:10.1371/journal.pone.0125096. PMC 4411061. PMID 25915929.
  4. ↑ Swinson RP (December 2006). "The GAD-7 scale was accurate for diagnosing generalised anxiety disorder". Evidence-Based Medicine. 11 (6): 184. doi:10.1136/ebm.11.6.184. PMID 17213178. S2CID 42283551.
  5. ↑ Plummer F, Manea L, Trepel D, McMillan D (2016-03-01). "Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis". General Hospital Psychiatry. 39: 24–31. doi:10.1016/j.genhosppsych.2015.11.005. PMID 26719105.
  6. ↑ Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B (March 2007). "Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection". Annals of Internal Medicine. 146 (5): 317–25. doi:10.7326/0003-4819-146-5-200703060-00004. hdl:2027.42/151274. PMID 17339617. S2CID 28019277.
  7. ↑ Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, Herzberg PY (March 2008). "Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population". Medical Care. 46 (3): 266–74. doi:10.1097/MLR.0b013e318160d093. JSTOR 40221654. PMID 18388841. S2CID 16052239.
  8. 1 2 De Man J, Absetz P, Sathish T, Desloge A, Haregu T, Oldenburg B, et al. (2021-05-13). "Are the PHQ-9 and GAD-7 Suitable for Use in India? A Psychometric Analysis". Frontiers in Psychology. 12: 676398. doi:10.3389/fpsyg.2021.676398. PMC 8155718. PMID 34054677.
  9. ↑ Spitzer RL, Kroenke K, Williams JB, Löwe B (May 2006). "A brief measure for assessing generalized anxiety disorder: the GAD-7". Archives of Internal Medicine. 166 (10): 1092–7. doi:10.1001/archinte.166.10.1092. PMID 16717171.
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