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

5100 Scopus citations

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

ASJC Scopus subject areas

  • Internal Medicine

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