GAD-7 questionnaire for anxiety symptoms

GAD-7 (Generalized Anxiety Disorder) measures how often seven anxiety symptoms have bothered you 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 developed in patients seen in primary care. Anxiety and depression remain separate dimensions, even though they often occur together. Like the PHQ-9 (for depression), the GAD-7 form is free for anyone to use.

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.

For cutoffs between 7 and 10 points, sensitivity and specificity are acceptable [2]. A score of 10 or above is therefore a good reason to raise the subject with a doctor.

Anxiety is more common in patients with diabetes, and some of the symptoms overlap with those of the disease itself [3]. That is why anxiety symptoms are screened for in all patients with diabetes at least once a year [4]. Restlessness, tremor, sweating and a pounding heart are also signs of hypoglycemia, which sometimes makes it hard to tell what is going on. If you have these signs and you are treated with insulin or with tablets that can cause hypoglycemia, check your blood glucose before putting them down to anxiety [5].

There is also a distinct form, fear of hypoglycemia, which appears for instance after a severe hypoglycemic episode and can lead to deliberately keeping blood glucose too high [4]. If you recognize the pattern, read about hypoglycemia and how to prevent it, then bring it up at your next appointment.

No. 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 often overlap, 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 can find it on the PHQ-9 questionnaire page.