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What does the GAD-7 questionnaire measure?
GAD-7 (Generalized Anxiety Disorder) measures how intense seven anxiety symptoms have been over the last two weeks. Each question is scored from 0 to 3, so the total runs from 0 to 21 [1].
The scale was built on almost 3000 primary care patients, and the authors showed that anxiety and depression remain separate dimensions, even though they often occur together. Like PHQ-9 (which covers depression), the GAD-7 form is free for anyone to use.
What does my GAD-7 score mean?
The published cutoffs are 5, 10 and 15 points, separating minimal symptoms from mild, moderate and severe anxiety [1]. The usual threshold for referral is 10.
A meta-analysis of twelve studies, with over 5000 participants, found acceptable sensitivity and specificity for cutoffs between 7 and 10 points [2]. A score of 10 or above is therefore a good reason to raise the subject with a doctor.
What is the link between anxiety and diabetes?
Anxiety is more common in patients with diabetes, and some of the symptoms overlap with those of the disease itself. Restlessness, tremor, sweating and a pounding heart are also signs of hypoglycemia, which sometimes makes it hard to tell what is going on.
There is also a distinct form, fear of hypoglycemia, which appears for instance after a severe hypoglycemic episode and leads to deliberately keeping blood glucose too high. If you recognize the pattern, read about hypoglycemia and how to prevent it, then bring it up at your next appointment.
Do GAD-7 and PHQ-9 measure the same thing?
No. The factor analysis carried out by the authors showed that the two scales measure distinct dimensions, with independent effects on daily functioning [1]. Anxiety revolves around worry and restlessness, depression around loss of interest and discouragement.
They overlap often, and many people score high on both. That is why the two questionnaires are usually completed together, and if you have not done the other one yet you will find it at the PHQ-9 questionnaire.
Glossary terms used here