What this anxiety test measures
The GAD-7 is a seven-question questionnaire about how often you have been bothered by symptoms of anxiety over the last two weeks [1]. It was designed to pick out likely cases of generalised anxiety disorder and to measure how severe the symptoms are [1].
The questions ask about:
- feeling nervous, anxious or on edge
- not being able to stop or control worrying
- worrying too much about different things
- trouble relaxing
- being so restless that it is hard to sit still
- becoming easily annoyed or irritable
- feeling afraid that something awful might happen
Who developed it
The GAD-7 was developed by Robert Spitzer, Kurt Kroenke, Janet Williams and Bernd Löwe, and published in 2006 [1]. In the original study, 2,740 adults in 15 primary care clinics filled it in, and 965 of them also had a telephone interview with a mental health professional [1].
A follow-up study of the same patients found that the GAD-7 also worked as a first screen for panic disorder, social anxiety disorder and post-traumatic stress disorder [3]. It was built for generalised anxiety, though, and a high score does not show which kind of anxiety is involved.
How the GAD-7 is scored
Each question has four answers, scored from 0 to 3 [1]:
| Answer | Points |
|---|---|
| Not at all | 0 |
| Several days | 1 |
| More than half the days | 2 |
| Nearly every day | 3 |
The seven answers add up to a total between 0 and 21 [1]. The authors suggested that cut points of 5, 10 and 15 can be read as mild, moderate and severe levels of anxiety [1]:
| Total score | Level |
|---|---|
| 0-4 | Minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-21 | Severe |
A last question asks how difficult the problems have made it to work, look after things at home or get along with other people. It is not part of the 0 to 21 total, but it is worth noting. In the original study, higher GAD-7 scores were strongly linked with problems in daily functioning and with more days lost to disability [1].
What your result can and cannot tell you
Your score is a snapshot of the last two weeks. It can help you put words to how you have been feeling, give you something specific to take to your GP, and show whether things shift if you take it again later.
It cannot diagnose an anxiety disorder. The GAD-7 is a screening questionnaire. The NHS points out that most people feel anxious sometimes, and that this does not always mean generalised anxiety disorder [5]. It is more likely to be generalised anxiety disorder if you feel anxious most of the time and it affects your everyday life [5]. Only a health professional who talks it through with you can judge that.
How accurate is it?
In the original study, a cut-off of 10 gave a sensitivity of 89% and a specificity of 82% for generalised anxiety disorder [1]. A later review of 11 samples found the GAD-7 performed acceptably at cut-offs anywhere from 7 to 10 [2].
A 2025 Cochrane review pooled 48 studies with 19,228 people from 27 countries [4]. At a cut-off of 10, the GAD-7 picked up 64% of people with generalised anxiety disorder, and correctly cleared 91% of people without it [4]. The reviewers said these figures should be read as rough averages, because the studies varied so much [4].
Two things follow from this:
- A low score does not rule a problem out. On the Cochrane figures, roughly a third of people with generalised anxiety disorder scored below 10 [4]. If you are struggling, that matters more than the number.
- A high score is a reason to talk to someone, not a finding in itself.
What to do next in the UK
- If your score is under 5 and you feel you are coping, you may not need to do anything now. Take the test again if things change.
- If your score is 10 or more, or the worry is wearing you down whatever the score, speak to your GP. The NHS suggests seeing a GP if you think you might have generalised anxiety disorder [5].
- In England, if you are 18 or over you can refer yourself to an NHS talking therapies service without a referral from a GP [5]. Some areas also accept 16 and 17-year-olds, and you do not need a diagnosis [6].
- In Scotland, your GP practice is the first place to go when it is open [8]. Breathing Space offers a free phone line for anyone in Scotland over 16 who is feeling low, anxious or depressed, on 0800 83 85 87 [14]. It is open Monday to Thursday from 6pm to 2am, and from 6pm Friday to 6am Monday [14].
- In Northern Ireland, your GP may treat you directly or refer you to mental health services [11].
- In Wales, start with your GP practice. If your GP refers you to local primary mental health services, those services have a duty to assess you [15]. Our guide to getting help in the UK sets out the routes in each nation.
If you need help now
Anxiety can sometimes become overwhelming. If you feel unable to cope or unsafe:
- If a life is at risk or you cannot keep yourself or someone else safe, call 999 or go to A&E [7].
- England: call 111 and select the mental health option [7].
- Scotland: phone NHS 24 on 111 and choose the mental health option [8].
- Wales: call 111 and press option 2, which is free and open 24 hours a day for all ages [9].
- Northern Ireland: call Lifeline free on 0808 808 8000, open 24 hours every day [10].
- Anywhere in the UK: call Samaritans free on 116 123 at any time [12], or text the word SHOUT to 85258, which is free and open 24/7 [13].