GAD-7 Calculator — Anxiety Screening After Stroke
Score the GAD-7, read the severity band, and see the stroke-specific context: anxiety affects roughly a quarter of survivors, travels with depression, and quietly blocks rehab participation and community re-entry.
Reviewed by Zaka Ahmed, MD Clinical reference · 3 min read
GAD-7
"Over the last 2 weeks, how often have you been bothered by the following problems?" Score each item: Not at all (0) · Several days (+1) · More than half the days (+2) · Nearly every day (+3).
0 of 7 items complete
Score every item to see the severity band and suggested next step.
Educational tool only. The GAD-7 screens for generalized anxiety and performs reasonably for panic and social anxiety, but a positive screen requires clinical interview. It does not replace clinical judgment or in-person evaluation.
Clinical notes & interpretation Scoring guidance, pitfalls, FAQs, and references
Anxiety after stroke: the quieter twin of post-stroke depression
Around a quarter of stroke survivors experience clinically significant anxiety, and it frequently coexists with depression — screening for one without the other misses treatable illness. The stroke-specific phenotypes are worth naming: fear of recurrence (often triggered by every transient sensory blip), fear of falling, health-related hypervigilance, and social anxiety about visible deficits. Untreated anxiety reduces rehab participation, delays driving and return to work, and narrows life more than the motor deficit itself in some patients.
Using the score well
Ten or more is the conventional threshold for a diagnostic conversation; 5, 10, and 15 mark mild, moderate, and severe bands. As with the PHQ-9, trends across visits beat single values, aphasia limits validity, and somatic overlap (restlessness, irritability, poor sleep from hospitalization or steroids) can inflate scores modestly. Fear of recurrence deserves a targeted response rather than a generic anxiolytic: walking the patient through their specific mechanism and the secondary-prevention plan — "here is why your stroke happened, and here is what is different now" — is itself an effective intervention.
Frequently asked questions.
What GAD-7 score is considered positive?
Ten or more warrants diagnostic assessment for generalized anxiety disorder (89% sensitivity, 82% specificity in the original validation). Bands: 0–4 minimal, 5–9 mild, 10–14 moderate, 15–21 severe.
Does the GAD-7 detect panic disorder or PTSD after stroke?
It performs reasonably as a broad screen for panic and social anxiety but is not designed for PTSD — which occurs after stroke more often than commonly appreciated. If intrusive re-experiencing of the event, avoidance, or hyperarousal dominate, screen specifically for PTSD.
Which comes first — treating anxiety or depression?
They usually travel together and first-line treatments overlap (SSRIs, CBT). Screen for both, treat the syndrome that dominates, and reassess both scores on follow-up.
References.
- Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. PubMed
- Knapp P, Dunn-Roberts A, Sahib N, et al. Frequency of anxiety after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke. 2020;15(3):244–255. PubMed