GAD-7 Anxiety Screening Calculator

How to Use This Calculator

1. Rate each of the 7 items for the past 2 weeks using the 0–3 scale.
2. Total score and severity appear instantly.
3. GAD-2 tab: quick 2-item pre-screen.
4. Anxiety+Depression tab: assess comorbid symptom burden with PHQ-9.
5. Professional tier: full clinical assessment with functional impact and disorder screening.

Formula

Example

Frequently Asked Questions

• What is the GAD-7 and what does it measure? ▼
  The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated, self-administered questionnaire developed by Robert Spitzer, Kurt Kroenke, Janet Williams, and Bernd Löwe, first published in the Archives of Internal Medicine in 2006. It was developed as a companion to the PHQ-9 for use in primary care settings. The seven items correspond to the DSM diagnostic criteria for generalized anxiety disorder: excessive nervousness, uncontrollable worry, worry about multiple domains, difficulty relaxing, restlessness, irritability, and fear of impending doom. Each item is rated on a 0–3 scale over the past two weeks (not at all to nearly every day), producing scores from 0 to 21. The GAD-7 has demonstrated high sensitivity (89%) and specificity (82%) for generalized anxiety disorder at a cut-point of 10. It also performs well as a screen for panic disorder, social anxiety disorder, and post-traumatic stress disorder, though sensitivity is lower for these conditions. The GAD-7 is endorsed by the NICE guidelines in the UK and widely recommended by primary care organizations internationally.
• How should GAD-7 scores be interpreted? ▼
  The GAD-7 severity bands were established in the original 2006 validation study. Scores of 0–4 indicate minimal anxiety; these patients rarely require active treatment and may benefit from reassurance and lifestyle advice. Scores of 5–9 represent mild anxiety; clinical judgment determines whether watchful waiting, psychoeducation, or self-help resources are appropriate. Scores of 10–14 indicate moderate anxiety and are associated with significant functional impairment in many patients; evidence-based treatment — primarily cognitive behavioural therapy (CBT), either face-to-face or online, and/or pharmacotherapy with an SSRI or SNRI — should be initiated. Scores of 15–21 represent severe anxiety; active combined treatment with both psychotherapy and pharmacotherapy is generally indicated, and referral to mental health services should be considered for patients who do not respond to initial interventions. The functional impairment question (how difficult have these problems made it to carry out daily activities?) supplements score interpretation — patients with functional impairment at lower total scores may warrant more aggressive intervention.
• How does the GAD-7 compare to other anxiety measures? ▼
  The GAD-7 is one of several validated anxiety instruments used clinically and in research, each with different strengths. The State-Trait Anxiety Inventory (STAI) is a longer, research-oriented tool distinguishing state from trait anxiety; it is more comprehensive but too lengthy for routine clinical screening. The Beck Anxiety Inventory (BAI) focuses on somatic symptoms of anxiety and is well-validated but slightly less sensitive for psychological anxiety symptoms compared to the GAD-7. The Hospital Anxiety and Depression Scale (HADS) anxiety subscale has 7 items and was designed specifically to reduce the influence of somatic illness on anxiety scores in medically unwell patients; it performs comparably to GAD-7 in this population. The GAD-2 (first two items of GAD-7) functions as an ultra-brief screen; a score of 3 or above has 86% sensitivity for GAD. The Penn State Worry Questionnaire (PSWQ) measures worry severity specifically rather than full anxiety disorder and is useful for monitoring cognitive aspects of GAD treatment. For clinical practice, the GAD-7 offers the best balance of brevity, validity across anxiety disorder types, and free availability, making it the most commonly used anxiety screener in primary care.
• Can the GAD-7 diagnose an anxiety disorder? ▼
  The GAD-7 is a screening and severity measurement tool — it is not a diagnostic instrument. A positive screen (score ≥10) indicates a high probability of clinically significant anxiety but does not constitute a diagnosis. The formal diagnosis of generalized anxiety disorder requires a structured clinical assessment based on DSM-5 or ICD-11 criteria, which includes confirming that the worry is difficult to control, occurs more days than not for at least 6 months, is associated with physical symptoms (fatigue, muscle tension, sleep problems, concentration difficulty, irritability), and causes significant distress or functional impairment not better explained by substance use, another medical condition, or another psychiatric disorder. The GAD-7 can also screen for panic disorder, social anxiety disorder, and PTSD at a cut-point of 10, though sensitivity varies (74–81% for these conditions versus 89% for GAD). A positive screen should prompt a full clinical history, mental status examination, and consideration of physical causes such as thyroid disease, caffeine excess, cardiac arrhythmias, or medication side effects before a psychiatric diagnosis is made.
• How should the GAD-7 be used to monitor anxiety treatment? ▼
  The GAD-7 is most valuable when used serially rather than as a single-point assessment. Measurement-based care — routinely administering the GAD-7 at every clinical contact and tracking scores over time — has been shown to improve treatment outcomes in anxiety disorders, similar to its demonstrated benefit in depression care. At baseline, the score establishes severity and treatment threshold. After initiating treatment (pharmacotherapy or CBT), the GAD-7 should be repeated in 4–6 weeks to assess initial response. Response criteria are: remission (score ≤4), treatment response (≥50% reduction from baseline), partial response (25–49% reduction), and non-response (<25% reduction). Non-response after 8–12 weeks of adequate treatment should prompt reassessment of diagnosis, adherence, comorbid conditions, psychosocial stressors, and possible treatment adjustment. SSRI dose titration, augmentation, or switching to a different evidence-based treatment should be guided by objective score data. Discharge or step-down from intensive treatment can be considered when scores are consistently in the remission range and functional impairment has resolved. Maintenance monitoring (e.g., quarterly) helps identify early relapse.

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