Generalized Anxiety Disorder GAD 7 Calculator

How does this Generalized Anxiety Disorder GAD 7 calculator work?

This health calculator is based on the GAD 7 model and allows both clinicians and anyone else interested in assessing the most common anxiety symptoms, their occurrence in the behavior of the subject in the past weeks and obtain an overall anxiety severity score.

This Generalized Anxiety Disorder GAD 7 calculator discusses seven of the most common symptoms and manifestations of an anxious disorder and provides an easy to interpret score result:

■ Nervousness, feeling on the edge.

■ Uncontrollable worrying for no particular reason.

■ Exaggerated worrying even in situations that do not require so much thought or anxiety.

■ Difficulty relaxing or allowing leisure time.

■ Restlessness, inability to sit still.

■ Easily irritated, annoyed or frustrated.

■ Feelings of fear and a permanent sensation that something bad is going to happen.

Each of these 7 criteria are used in the GAD 7 questionnaire along with the following answers and their awarded number of points:

■ Not at all (0 points) – meaning that during the 2 weeks the subject is asked to think about, there was no moment when he/ she experienced the feelings described.

■ Several days (1 point) – pointing out that in some days, there have been experienced those sensations.

■ More than half the days (2 points) – explaining that in more than 7 out of the 14 days analyzed, the subject has experienced the symptoms described.

■ Nearly every day (3 points) – indicates that almost every day in the past two weeks, the subject has experienced the feelings referred to.

The clinicians using the GAD 7 are also advised to end the test by asking the patient about the other difficulties they might be experiencing and about how easy they find dealing with day to day activities, a question similar to those in other anxiety scales (e.g. Hamilton). Although not used in the final score, the answer to this question can show progress or allow a tracking of the overall response to anxiety.

GAD 7 score interpretation

The above questionnaire works as a quick screening tool allowing the subject or the assessor to see whether an anxiety disorder is present and to what degree. Since all the 7 questions have answers graded 0 to 3 points, the extreme values are 0 points – no anxiety and 21 points – severe anxiety.

■ 0 - 4 points – This score is considered not to indicate the presence of any anxiety disorder but certain signs and these common symptoms should continue to be monitored if there are still suspicions and the questionnaire should be refilled in a week/ 2 week time.

■ 5 - 9 – This score indicates the presence of mild anxiety disorder as reported by the subject answering the questions. As there are still suspicions and signs already present, monitoring needs to be started and the questionnaire should be refilled in a week/ 2 week time.

■ 10 - 14 – These are levels indicative of moderate anxiety disorder as reported by the subject answering the questions. Other quantitative and qualitative measures of psychological/ psychiatric tested should continue the evaluation further.

■ 15 - 21 – This score suggests a degree of severe anxiety disorder as reported by the subject answering the questions. The evaluation should be continued with more specific test and treatment should be started if it wasn’t already.

When to use the GAD 7?

This method of quiz screening can assess severity and provide an overall level in four anxiety disorders (the specificity and sensitivity are presented for scores above 10):

■ Generalized Anxiety Disorder – sensitivity 89%, specificity 82%.

■ Social Phobia  – sensitivity 74%, specificity 81%.

■ Panic Disorder – sensitivity 72%, specificity 80%.

■ Post Traumatic Stress Disorder – sensitivity 66%, specificity 81%.

In regard to sensibility considerations, this scoring system is considered to be 70 - 90% sensible and has a specificity across the disorders discussed above of around 85% which means it can be successfully used as primary tool in a quick evaluation.

However, these personality disorders also have specialized methods of screenings that should be used in order to get a more in depth knowledge of the situation presented.

References

1) Spitzer RL, Kroenke K, Williams JB. (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA; 282(18):1737-44.

2) Kroenke K, Spitzer RL, Williams JB, Löwe B. (2010) The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry; 32(4):345-59

3) Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. (2007) Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med; 146(5):317-25.