A brief measure for assessing generalized anxiety disorder: The GAD-7

Robert L. Spitzer, Kurt Kroenke, Janet B W Williams, Bernd Löwe

Research output: Contribution to journalArticle

4550 Citations (Scopus)

Abstract

Background: Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. Methods: A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. Results: A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. Conclusion: The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

Original languageEnglish
Pages (from-to)1092-1097
Number of pages6
JournalArchives of Internal Medicine
Volume166
Issue number10
DOIs
StatePublished - May 22 2006

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Anxiety Disorders
Self Report
Mental Health
Interviews
Depression
Health Surveys
Reproducibility of Results
Mental Disorders
Statistical Factor Analysis
Primary Health Care
Anxiety
Outcome Assessment (Health Care)
Delivery of Health Care
Sensitivity and Specificity
Research

ASJC Scopus subject areas

  • Internal Medicine

Cite this

A brief measure for assessing generalized anxiety disorder : The GAD-7. / Spitzer, Robert L.; Kroenke, Kurt; Williams, Janet B W; Löwe, Bernd.

In: Archives of Internal Medicine, Vol. 166, No. 10, 22.05.2006, p. 1092-1097.

Research output: Contribution to journalArticle

Spitzer, Robert L. ; Kroenke, Kurt ; Williams, Janet B W ; Löwe, Bernd. / A brief measure for assessing generalized anxiety disorder : The GAD-7. In: Archives of Internal Medicine. 2006 ; Vol. 166, No. 10. pp. 1092-1097.
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