GAD-2
Two-item anxiety screen (core items of the GAD-7)
Sources last checked: 2026-10-13
GAD-2
Two-item anxiety screen (core items of the GAD-7)
A screen, not a diagnosis. A negative GAD-2 does not exclude panic or social anxiety disorder.
Interpretation
| 0–2 — negative screen | Below the usual cut-off. |
|---|---|
| 3–6 — positive screen | ≥ 3 is the cut-off with acceptable accuracy for generalised anxiety disorder (pooled sensitivity 0.76, specificity 0.81). A screen, not a diagnosis; the GAD-2 consists of the first two GAD-7 items. |
What is the GAD-2?
The GAD-2 uses the first two items of the GAD-7 — nervousness and uncontrollable worry — each rated 0–3 for the last two weeks. Kroenke and colleagues described it in 2007 in 965 primary-care patients as a brief screen for the common anxiety disorders.
When to use it
- Very brief anxiety screening in primary care or in combined questionnaires
- As a gate to the full GAD-7
- Alongside the PHQ-2 (together the PHQ-4)
When not to use it
- To grade severity or monitor treatment — use the GAD-7
- As a diagnosis
How it is calculated
| Criterion | Points |
|---|---|
| 1. Feeling nervous, anxious, or on edge | |
| Not at all | 0 |
| Several days | 1 |
| More than half the days | 2 |
| Nearly every day | 3 |
| 2. Not being able to stop or control worrying | |
| Not at all | 0 |
| Several days | 1 |
| More than half the days | 2 |
| Nearly every day | 3 |
Clinical pearls and limitations
- A screen, not a diagnosis. A negative GAD-2 does not exclude panic or social anxiety disorder.
- A score of 3 or more is the commonly used cut-off; pooled sensitivity is about 0.76 and specificity 0.81 for GAD.
- A negative GAD-2 does not exclude anxiety disorders other than GAD.
- PHQ-2 and GAD-2 together form the four-item PHQ-4.
Frequently asked questions
What is a positive GAD-2?
3 or more out of 6. In a two-step pathway the GAD-7 and a clinical assessment follow.
What is the PHQ-4?
The PHQ-2 plus the GAD-2: four items covering depression and anxiety, each pair scored separately.
Can I use the GAD-2 alone?
As a first-step screen, yes. For severity and monitoring use the GAD-7.
Evidence and guidelines
- Primary source: Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007;146(5):317-325.
- Plummer F et al. Screening for anxiety disorders with the GAD-7 and GAD-2: systematic review and diagnostic meta-analysis. Gen Hosp Psychiatry 2016;39:24-31 (GAD-2 cut-off 3).
Have a follow-up question?
Medelix answers clinical questions from current guidelines and studies — every statement with its source.
Ask Medelix about the GAD-2Related calculators
Embed this calculatorFree to use on your website, intranet or teaching page. Copy the code below.
<iframe src="https://medelix.ai/en/embed/gad-2" title="GAD-2 – Medelix" width="100%" height="620" style="border:0;max-width:720px" loading="lazy"></iframe>
<p><a href="https://medelix.ai/en/calculators/gad-2">GAD-2 calculator by Medelix</a></p>For healthcare professionals and medical students. These tools support, and do not replace, clinical judgement. Always check results against the original source and your local protocols.