GAD-7 and PHQ-9

What is GAD-7

Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD).[1] GAD-7 has seven items, which measure severity of various signs of GAD according to reported response categories with assigned points (see below). Assessment is indicated by the total score, which made up by adding together the scores for the scale all seven items.[2]

GAD-7 is a sensitive self-administrated test to assess generalized anxiety disorder,[3] normally used in outpatient and primary care settings for referral to psychiatrist pending outcome.[4] However, it cannot be used as replacement for clinical assessment and additional evaluation should be used to confirm a diagnosis of GAD.

The scale uses a normative system of scoring with question at the end qualitatively describing severity of the patient's anxiety over the past 2 weeks.[4]

GAD-7 scoring

The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of 'not at all', 'several days', 'more than half the days', and 'nearly every day', respectively, and adding together the scores for the seven questions.

Scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate and severe anxiety, respectively. When used as a screening tool, further evaluation is recommended when the score is 10 or greater.

GAD-7 Anxiety Severity

Scores represent: 0-5 mild. 6-10 moderate. 11-15 moderately severe anxiety. 15-21 severe anxiety. 

What is PHQ-9

The PHQ-9 (DEP-9 in some sources[5]) is a 9-question instrument given to patients in a primary care setting to screen for the presence and severity of depression. It is the 9-question depression scale from the Patient Health Questionnaire (PHQ). The results of the PHQ-9 may be used to make a depression diagnosis according to DSM-IV criteria and takes less than 3 minutes to complete. The total of all 9 responses from the PHQ-9 aims to predict the presence and severity of depression. Primary care providers frequently use the PHQ-9 to screen for depression in patients.

PHQ-9 scoring

It is not a screening tool for depression, but it is used to monitor the severity of depression and response to treatment. However, it can be used to make a tentative diagnosis of depression in at-risk populations - eg, those with coronary heart disease or after stroke.

PHQ-9 Depression Severity

Scores represent: 0-5 mild. 6-10 moderate. 11-15 moderately severe anxiety. 15-21 moderately severe. 15-21 severe depression.

Reference

  1. Spitzer, Robert L.; Kroenke, Kurt; Williams, Janet B.W.; Löwe, Bernd (22 May 2006). "A brief measure for assessing generalized anxiety disorder: The GAD-7". Archives of Internal Medicine. 166 (10): 1092–7. doi:10.1001/archinte.166.10.1092. PMID 16717171.

  2. ^ Swinson, Richard P. (December 2006). "The GAD-7 scale was accurate for diagnosing generalized anxiety disorder". Evidence-Based Medicine. 11 (6): 184. doi:10.1136/ebm.11.6.184. PMID 17213178.

  3. ^ Kroenke, Kurt; Spintzer, Robert L.; Williams, Janet B.W.; Monahan, Patrick O.; Löwe, Bernd (6 March 2007). "Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection". Annals of Internal Medicine. 146 (5): 317–25. doi:10.7326/0003-4819-146-5-200703060-00004. PMID 17339617.

  4. ^ Jump up to: a b Löwe, Bernd; Decker, Oliver; Müller, Stefanie; Brähler, Elmar; Schellberg, Dieter; Herzog, Wolfgang; Herzberg, Philipp Yorck (2008). "Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population". Medical Care. 46 (3): 266–74. doi:10.1097/mlr.0b013e318160d093. PMID 18388841.

  5. Grassi, Luigi; Riba, Michelle (2012-05-18). Clinical Psycho-Oncology: An International Perspective. ISBN 9781119941095.