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GAD-7 Anxiety

Please fill out the following form.

Date
Month
Day
Year

Over the last two weeks, how often have you  been bothered by the following problems? 

Not at all  Several  days  More than half  the days Nearly  everyday 

1. Feeling nervous, anxious, or on edge
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
2. Not being able to stop or control worrying
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
3. Worrying too much about different things
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
4. Trouble relaxing
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
5. Being so restless that it is hard to sit still
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
6. Becoming easily annoyed or irritable
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
7. Feeling afraid, as if something awful might happen
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
If you checked any problems, how difficult have they made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult

Source: Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD-PHQ). The PHQ was  developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues. For research information, contact Dr. Spitzer at ris8@columbia.edu. PRIME-MD® is a trademark of Pfizer Inc. Copyright© 1999 Pfizer Inc. All rights reserved.  Reproduced with permission 

Scoring GAD-7 Anxiety Severity  

This is calculated by assigning scores of 0, 1, 2, and 3 to the response categories, respectively,  of “not at all,” “several days,” “more than half the days,” and “nearly every day.”  GAD-7 total score for the seven items ranges from 0 to 21.  

0–4: minimal anxiety  

5–9: mild anxiety  

10–14: moderate anxiety  

15–21: severe anxiety  

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