Generalised Anxiety Disorder Scale (GAD-7)
Seven-item measure of generalised anxiety severity, and a sound first screen for panic, social anxiety and PTSD.
Last reviewed: May 2026
The GAD-7 was developed by Spitzer, Kroenke, Williams and Löwe (2006) as a brief measure of generalised anxiety. Its seven items ask how often a person has been bothered by symptoms such as feeling nervous, being unable to stop worrying, restlessness and irritability over the past two weeks.
Scoring & Interpretation
Each of the seven items is rated 0 (not at all) to 3 (nearly every day) over the past two weeks. ClientForms sums the seven responses to a total of 0 to 21 and maps it to the four severity bands below. A score of 10 or above is the standard cut-off for clinically significant anxiety. A separate, unscored question asks how difficult the symptoms have made daily functioning, which is recorded alongside the total rather than added to it.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 0-4 | Minimal | Minimal anxiety: no action usually needed |
| 5-9 | Mild | Mild symptoms: watchful waiting, repeat at follow-up |
| 10-14 | Moderate | At or above the cut-off of 10: probable anxiety disorder, assess further |
| 15-21 | Severe | Active treatment; assess the specific anxiety disorder and review supports |
At the cut-off of 10 or above, the GAD-7 has a sensitivity of 0.89 and specificity of 0.82 for generalised anxiety disorder (Spitzer et al., 2006). Internal consistency is excellent (Cronbach's alpha 0.92) and test-retest reliability is high (ICC = 0.83). The same cut-off provides a reasonable screen for panic, social anxiety and PTSD, with accuracy declining as it is applied beyond generalised anxiety.
When to Use This vs Alternatives
Use PHQ-9 when…
Low mood rather than worry is the presenting concern, or you want to screen both. The GAD-7 measures anxiety severity; the PHQ-9 does the same for depression, and the two are routinely administered together.
View PHQ-9 →Use DASS-21 when…
You want depression, anxiety and stress as three separate subscales from one form. The DASS-21 separates the components; the GAD-7 gives a focused anxiety severity score that doubles as an outcome measure.
View DASS-21 →Use K-10 when…
You want a single index of overall psychological distress rather than an anxiety-specific score. The K-10 is the distress measure psychologists submit for Better Access in Australia; the GAD-7 gives an anxiety-specific severity score.
View K-10 →See It in Action
- 1Total anxiety score on the 0-to-21 scale with its severity band
- 2Score plotted against the four bands and the cut-off of 10
- 3Each item response listed with its individual score
- 4One-click PDF export and email delivery for the patient record
What It Measures
The GAD-7 was developed by Spitzer, Kroenke, Williams and Löwe (2006) as a brief measure of generalised anxiety. Its seven items ask how often a person has been bothered by symptoms such as feeling nervous, being unable to stop worrying, restlessness and irritability over the past two weeks. Although built for generalised anxiety disorder, it performs well as a screen for panic disorder, social anxiety disorder and post-traumatic stress disorder, and is the most widely used anxiety measure in primary care.
When to Use the GAD-7
Use the GAD-7 to screen for anxiety, gauge its severity and track change over a course of care. It is brief enough to repeat at each review and is routinely paired with the PHQ-9 so depression and anxiety are captured together. It is a severity measure, not a diagnosis: a raised score indicates anxiety symptoms that warrant assessment, while the diagnosis and formulation remain the practitioner's judgement. A high score alongside a specific presentation is a prompt to assess the relevant anxiety disorder directly.
Who It's For
Adults aged 18 and over, validated in primary-care and general-population samples internationally. Self-report: the patient completes it themselves. The GAD-2 is the first two items, used as an ultra-brief first-step screen; a positive GAD-2 is followed by the full GAD-7. It is widely used with adolescents, though it was validated in adults.
Frequently Asked Questions
What does the GAD-7 measure?
The GAD-7 is a seven-item self-report measure of generalised anxiety severity over the past two weeks. It also works as a screen for panic disorder, social anxiety and PTSD.
How is the GAD-7 scored, and what is the cut-off?
Each item is rated 0 to 3 and the seven responses are summed to a total of 0 to 21. A score of 10 or above is the standard cut-off for clinically significant anxiety, with bands at 5, 10 and 15.
What do the GAD-7 severity bands mean?
A total of 0 to 4 indicates minimal anxiety, 5 to 9 mild, 10 to 14 moderate and 15 to 21 severe. The bands suggest a level of severity; the clinical interpretation remains the practitioner's.
What is the difference between the GAD-7 and GAD-2?
The GAD-2 is the first two items of the GAD-7, used as an ultra-brief first-step screen. A positive GAD-2 (a score of 3 or more) is followed by the full GAD-7 for a severity score.
Is the GAD-7 free to use?
Yes. The GAD-7 is free to use, reproduce and translate without permission (Spitzer et al., 2006), which is one reason it is the most widely used anxiety measure in primary care.
How is the GAD-7 used for measurement-based care?
The GAD-7 is administered at intake and repeated at review to document change in anxiety severity. ClientForms scores it the moment the patient submits and produces a report you can attach to the treatment record.
Use the GAD-7 in your practice
New accounts get 30 days of full Professional access, no card. After that it stays on the Free plan. Scored the moment patients submit.