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Generalized Anxiety Disorder (GAD-7) (NM800043)

Generalized Anxiety Disorder (GAD-7) (NM800043) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Questionnaires



Patient Name

DOB:

MR #


NM800043 (Rev. 02/02/18) Worksheet Only – Not a Medical Record Document, DO NOT SCAN
UW Health
(University of Wisconsin Hospitals and Clinics Authority)
GENERALIZED ANXIETY DISORDER (GAD-7)




Date: __________________________________


GAD-7


Over the last 2 weeks, how often have you Not Several More than Nearly
been bothered by the following problems? at all days half the every day
days
(Please circle your answer)
___________________________________________________________________________________________________

1. Feeling nervous, anxious or on edge 0 1 2 3
___________________________________________________________________________________________________

2. Not being able to stop or control worrying 0 1 2 3
___________________________________________________________________________________________________

3. Worrying too much about different things 0 1 2 3
___________________________________________________________________________________________________

4. Trouble relaxing 0 1 2 3
___________________________________________________________________________________________________

5. Being so restless that it is hard to sit still 0 1 2 3
___________________________________________________________________________________________________

6. Becoming easily annoyed or irritable 0 1 2 3
___________________________________________________________________________________________________

7. Feeling afraid as if something awful might happen 0 1 2 3




(For office coding: Total Score T ______ = ______ + ______ + ______ )


Total
Score GAD-7 Score Interpretation
UWH Treatment Recommendations – Patient
Preferences should be considered
>=10
Probable diagnosis of generalized anxiety
disorder (GAD); confirm by further evaluation Score suggests anxiety treatment may not be needed
5 Mild anxiety
Support, educate to call if worse, return in one month (and
repeat GAD 7)
10 Moderate anxiety* Support, pharmacotherapy and/or psychotherapy
15 Severe anxiety* Support, pharmacotherapy and/or psychotherapy

*GAD-7 > or = to 10; probable diagnosis of Generalized Anxiety Disorder (GAD), confirm by further evaluation


Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required
to reproduce, translate, display or distribute.