Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)

Toussaint, Anne; Hüsing, Paul; Gumz, Antje; Wingenfeld, Katja; Härter, Martin; Schramm, Elisabeth; Löwe, Bernd

doi:10.1016/j.jad.2020.01.032

Cited by 641Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)

Toussaint, Anne, Hüsing, Paul, Gumz, Antje, Wingenfeld, Katja, Härter, Martin, Schramm, Elisabeth, Löwe, Bernd·2020·Journal of Affective Disorders

DOI 10.1016/j.jad.2020.01.032

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Abstract

Background Effective treatment requires regular follow-up and monitoring of symptoms. We investigated sensitivity to change and minimal clinically important difference of the Generalized Anxiety Disorder Scale (GAD-7).Methods This study included all participants from a multisite trial of chronic depression. Baseline and follow-up (12 and 48 weeks) data were used to assess treatment response. Effect sizes (ES) and standardized response means (SRM) of pre- and post-GAD-7 mean changes were calculated for subgroups of patients, who did or did not improve according to ratings in the Hamilton Rating Scale for Depression (HRSD-24).Results N = 261 patients were included in the analyses. In the subgroup of patients who improved according to HRSD-24, GAD-7 scores were significantly lower after 12 weeks (t = -6.31, df = 120, p < .001; ES = -0.51, SRM = -0.57), and 48 weeks of treatment (t = -12.68, df = 141, p < .001; ES = -1.0, SRM = -1.7), when compared to admission. In the group who worsened, GAD-7 scores were significantly higher after 12 weeks (t = 2.96, df = 41, p = .005; ES = 0.30, SRM = 0.46), and increased after 48 weeks (t = 1.99, df = 21, p = .059; ES = 0.37, SRM = 0.43), when compared to baseline. The unchanged group showed no significant difference between baseline and follow-up. MCID was estimated 4 points on the GAD-7 total score.Limitations Confirmation of these findings and further investigation of the GAD-7 in populations and trials focusing on anxiety-specific treatment is highly recommended.Conclusions Results show that the GAD-7 is sensitive to detect change in psychopathology over the course of treatment.

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The minimal clinically important difference for GAD-7 was 3.8, and the clinically relevant change was ≥4 points.
“The minimal clinically important difference for GAD-7 was 3.8; the clinically relevant change was ≥4 points [51].”
From Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial (2021) · cites this paper as [51]
The observed change in anxiety (GAD-7 = 3.2 ± 4.5) met the minimal clinically important difference estimated at 4 points on the GAD-7 total score.
“This change met the level of minimal clinical important difference (MCID), which is estimated at 4 points on the GAD-7 total score [30].”
From The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review (2022) · cites this paper as [30]
The minimal clinically important difference for the GAD-7 total score is estimated at 4 points.
“which is estimated at 4 points on the GAD-7 total score [30].”
From The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review (2022) · cites this paper as [30]
Anxiety will be measured with the 7-item Generalized Anxiety Disorder Scale (GAD-7).
“Anxiety will be measured with the 7-item Generalized Anxiety Disorder Scale (GAD-7; range, 0–21; higher scores indicate greater severity) [25].”
From Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial (2022) · cites this paper as [25]
The study observed clinically meaningful improvements in both anxiety and depression, with reductions in GAD-7 (-5.04) and PHQ-9 (-5.64) higher than the MCID for both conditions (3.8 and 5, respectively).
“As noted above, we observed clinically meaningful improvements in both anxiety and depression, with reductions in GAD-7 (− 5.04) and PHQ-9 (− 5.64) higher than the MCID for both conditions (3.8 and 5, respectively) [66, 67].”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [66]

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Profiles of sleep changes during the COVID‐19 pandemic: Demographic, behavioural and psychological factors
Robillard, R., Dion, K., Pennestri, M., Solomonova, E., Lee, E. K., Saad, M., Murkar, A., Godbout, R., Edwards, J. D., Quilty, L. C., et al. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13231 · Cited by 164 · see citing works
“…based on previously established thresholds: difference of at least three points on the PSQI (Hughes et al., 2009); 28.0% change on the PSS (Eskildsen et al., 2015); difference of at least four points on the GAD-7 (Toussaint et al., 2020); and a 28.5% change on the QIDS-SR16 (Masson & Tejani, 2013).”
MethodInfluential
Impact of COVID‐19 on Psychology among the University Students
Dhar, B. K., Ayittey, F. K., & Sarkar, S. M. (2020) · Global Challenges · doi:10.1002/gch2.202000038 · Cited by 161 · see citing works
Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study
Singh, K., Kondal, D., Mohan, S., Jaganathan, S., Deepa, M., Venkateshmurthy, N. S., Jarhyan, P., Anjana, R. M., Narayan, K. M. V., Mohan, V., et al. (2021) · BMC Public Health · doi:10.1186/s12889-021-10708-w · Cited by 143 · see citing works
Trajectories of depression and anxiety symptoms during the COVID‐19 pandemic in a representative Australian adult cohort
Batterham, P. J., Calear, A. L., McCallum, S. M., Morse, A. R., Banfield, M., Farrer, L. M., Gulliver, A., Cherbuin, N., Harris, R. M. R., Shou, Y., et al. (2021) · The Medical Journal of Australia · doi:10.5694/mja2.51043 · Cited by 124 · see citing works
Emerging New Psychiatric Symptoms and the Worsening of Pre-existing Mental Disorders during the COVID-19 Pandemic: A Canadian Multisite Study: Nouveaux symptômes psychiatriques émergents et détérioration des troubles mentaux préexistants durant la pandémie de la COVID-19: une étude canadienne multisite
Robillard, R., Daros, A. R., Phillips, J. L., Porteous, M., Saad, M., Pennestri, M.-H., Kendzerska, T., Edwards, J. D., Solomonova, E., Bhatla, R., et al. (2021) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720986786 · Cited by 112 · see citing works
Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries
Leigh, J. P., Moss, S. J., White, T. M., Picchio, C. A., Rabin, K. H., Ratzan, S. C., Wyka, K., El-Mohandes, A. A. E., & Lazarus, J. V. (2022) · Vaccine · doi:10.1016/j.vaccine.2022.04.097 · Cited by 107 · see citing works
“In addition, the survey collected: 3) experience of anxiety (q21) and depression (q22) (moderate; 3–4 days per week, or most or all of the time; 5–7 days) [22]; 4) COVID-19 experience (self or a family member became ill with COVID-19 (q19), lost a family member to COVID-19 (q20)); 5) demographic variables (age, gender…”
Background
Predictive Factors for Impaired Mental Health among Medical Students during the Early Stage of the COVID-19 Pandemic in Morocco
Essangri, H., Sabir, M., Benkabbou, A., Majbar, M. A., Amrani, L., Ghannam, A., Lekehal, B., Mohsine, R., & Souadka, A. (2021) · The American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.20-1302 · Cited by 100 · see citing works
“The GAD-7 includes seven items based on seven core symptomsand inquires the frequencywithwhich respondents suffered from these symptoms within the last 2 weeks.(24) Respondents report their symptoms using a four-item Likert rating scale ranging from zero (not at all) to three (almost every day).”
Method
Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease
Bekelman, D. B., Feser, W. J., Morgan, B. R., Welsh, C. H., Parsons, E. C., Paden, G., Barón, A. E., Hattler, B. G. J., McBryde, C. F., Cheng, A. M., et al. (2024) · JAMA · doi:10.1001/jama.2023.24035 · Cited by 102 · see citing works
Psychological impact of the COVID-19 outbreak on students in a French region severely affected by the disease: results of the PIMS-CoV 19 study
Bourion-Bédès, S., Tarquinio, C., Batt, M., Tarquinio, P., Lebreuilly, R., Sorsana, C., Legrand, K., Rousseau, H., & Baumann, C. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113559 · Cited by 89 · see citing works
Relationship between school bullying and mental health status of adolescent students in China: A nationwide cross-sectional study
Luo, X., Zheng, R., Xiao, P., Xie, X., Liu, Q., Zhu, K., Wu, X., Xiang, Z., & Song, R. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103043 · Cited by 98 · see citing works
Prevalence of mental health problems and associated risk factors among military healthcare workers in specialized COVID ‐19 hospitals in Wuhan, China: A cross‐sectional survey
Pan, X., Xiao, Y., Ren, D., Xu, Z., Zhang, Q., Yang, L., Liu, F., Hao, Y., Zhao, F., & Bai, Y. (2020) · Asia-Pacific Psychiatry · doi:10.1111/appy.12427 · Cited by 79 · see citing works
“Consistent with a study by Toussaint, a GAD-7 score ≥ 5 was considered to indicate the existence of anxiety symptoms (Toussaint et al., 2020).”
Result
Prevalence and Correlation of Anxiety, Insomnia and Somatic Symptoms in a Chinese Population During the COVID-19 Epidemic
Huang, Y., Wang, Y., Zeng, L., Yang, J., Song, X., Rao, W., Li, H., Ning, Y., He, H., Li, T., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.568329 · Cited by 78 · see citing works
“These self-reported scales have good reliability and validity for measuring psychological status (11, 22, 23).”
Background
User Engagement and Clinical Impact of the Manage My Pain App in Patients With Chronic Pain: A Real-World, Multi-site Trial
Bhatia, A., Kara, J., Janmohamed, T., Prabhu, A., Lebovic, G., Katz, J., & Clarke, H. (2021) · JMIR mHealth and uHealth · doi:10.2196/26528 · Cited by 73 · see citing works
“These reductions have clinical significance, given that the minimum clinically important difference in values for the GAD-7 and PCS (–4 for GAD-7 [50] and 38% for PCS [51]) is within the 95% confidence interval of the outcome reduction.”
BackgroundInfluential
Effect of Online 1-Day Cognitive Behavioral Therapy–Based Workshops Plus Usual Care vs Usual Care Alone for Postpartum Depression: A Randomized Clinical Trial
Van Lieshout, R. J., Layton, H., Savoy, C. D., Brown, J. S. L., Ferro, M. A., Streiner, D. L., Bieling, P. J., Feller, A., & Hanna, S. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.2488 · Cited by 73 · see citing works
Predicting therapy outcome in a digital mental health intervention for depression and anxiety: A machine learning approach
Hornstein, S., Forman‐Hoffman, V. L., Nazander, A., Ranta, K., & Hilbert, K. (2021) · Digital Health · doi:10.1177/20552076211060659 · Cited by 79 · see citing works
“30,31 This dichotomization of the outcome was chosen to align with past approaches that also classi ﬁ ed outcomes.”
Method
The role of depression and anxiety in the relationship between poor sleep quality and subjective cognitive decline in Chinese elderly: Exploring parallel, serial, and moderated mediation
Xu, W., Lin, L., Ding, K., Ke, Y.-F., Huang, J.-H., Hou, C., Jia, F., & Wang, S. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.07.063 · Cited by 71 · see citing works
Predictors of Anxiety in the COVID-19 Pandemic from a Global Perspective: Data from 23 Countries
Burkova, V. N., Butovskaya, M., Randall, A. K., Fedenok, J. N., Ahmadi, K., AlGhraibeh, A. M. A., Allami, F. B. M., Alpaslan, F. S., Al-Zu’bi, M. A. A., Biçer, D. F., et al. (2021) · Sustainability · doi:10.3390/su13074017 · Cited by 64 · see citing works
“The increase in anxiety has resulted in an increase of both physical and psychological symptoms, such as feeling nervous, fearful, tense palpitations, hyperventilation and rapid breathing [20,21].”
Psychological Impact of the Civil War and COVID-19 on Libyan Medical Students: A Cross-Sectional Study
Elhadi, M., Buzreg, A., Bouhuwaish, A. E. M., Khaled, A., Alhadi, A., Msherghi, A. A. A., Alsoufi, A., Alameen, H., Biala, M. I., Elgherwi, A., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.570435 · Cited by 63 · see citing works
Temporomandibular disorders among medical students in China: prevalence, biological and psychological risk factors
Wu, J., Huang, Z., Chen, Y., Chen, Y., Pan, Z., & Gu, Y. (2021) · BMC Oral Health · doi:10.1186/s12903-021-01916-2 · Cited by 60 · see citing works
Associations of Uncertainty With Psychological Health and Quality of Life in Older Adults With Advanced Cancer
Verduzco-Aguirre, H. C., Babu, D. S., Mohile, S. G., Bautista, J., Xu, H., Culakova, E., Canin, B. E., Zhang, Y., Wells, M., Epstein, R. M., et al. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.08.012 · Cited by 55 · see citing works
“(21) Based on prior studies, minimal clinically important differences (MCID) were 3 points, 4-5 points, 2 points, 4-7 points and 1-2 points respectively for GAD-7, GDS-15, Distress Thermometer, FACT-G, and emotional well-being.(22-25)”
MethodResult
Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.
Hirsch, C. R., Krahé, C., Whyte, J., Krzyzanowski, H., Meeten, F., Norton, S., & Mathews, A. (2021) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000660 · Cited by 57 · see citing works
International consensus on patient-centred outcomes in eating disorders
Austin, A., de Silva, U., Ilesanmi, C., Likitabhorn, T., Miller, I., Fialho, M. D. L. S., Austin, S. B., Caldwell, B., Chew, C. S. E., Chua, S. N., et al. (2023) · The Lancet Psychiatry · doi:10.1016/s2215-0366(23)00265-1 · Cited by 53 · see citing works
Nonpharmacological management of psychological distress in people with COPD
Volpato, E., Farver-Vestergaard, I., Brighton, L. J., Peters, J. B., Verkleij, M., Hutchinson, A., Heijmans, M., & von Leupoldt, A. (2023) · European Respiratory Review · doi:10.1183/16000617.0170-2022 · Cited by 53 · see citing works
Clinical outcome data of anxiety patients treated with cannabis-based medicinal products in the United Kingdom: a cohort study from the UK Medical Cannabis Registry
Rifkin-Zybutz, R. P., Erridge, S., Holvey, C., Coomber, R., Gaffney, J., Lawn, W., Barros, D. A. R., Bhoskar, U., Mwimba, G., Praveen, K., et al. (2023) · Psychopharmacology · doi:10.1007/s00213-023-06399-3 · Cited by 52 · see citing works
“GAD-7 has been shown to be sensitive to change with a minimally clinically significant difference of 4 (Toussaint et al. 2020).”
BackgroundInfluential
The effect of anxiety on thriving levels of university students during the COVID-19 pandemic
Şahin, S., & Tuna, R. (2021) · Collegian Journal of the Royal College of Nursing Australia · doi:10.1016/j.colegn.2021.10.004 · Cited by 52 · see citing works
Patient-reported outcomes for people with diabetes: what and how to measure? A narrative review
Terwee, C. B., Elders, P. J. M., Blom, M. T., Beulens, J. W. J., Rolandsson, O., Rogge, A. A., Rose, M., Harman, N., Williamson, P. R., Pouwer, F., et al. (2023) · Diabetologia · doi:10.1007/s00125-023-05926-3 · Cited by 51 · see citing works
Validation of brief screening measures for depression and anxiety in young people with substance use disorders
Bentley, K. H., Sakurai, H., Lowman, K. L., Rines-Toth, L., McKowen, J. W., Pedrelli, P., Evins, A. E., & Yule, A. M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.005 · Cited by 51 · see citing works
“, 2006) are brief, widely-used self-report screening tools for depression and anxiety (Dear et al., 2011; Titov et al., 2011; Toussaint et al., 2020; Zimmerman, 2019).”
Method
Psychological interventions during COVID pandemic: Telehealth for individuals with cystic fibrosis and caregivers
Graziano, S., Boldrini, F., Righelli, D., Milo, F., Lucidi, V., Quittner, A. L., & Tabarini, P. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25413 · Cited by 49 · see citing works
“The MID score of 4 points, in either direction, has been established as a clinically meaningful change.(26) The Italian version of this instrument was used.”
Method
COVID‐19 impacts on drinking and mental health in emerging adults: Longitudinal changes and moderation by economic disruption and sex
Minhas, M., Belisario, K. L., González‐Roz, A., Halladay, J. E., Murphy, J. G., & MacKillop, J. M. (2021) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14624 · Cited by 48 · see citing works
The role of anxiety and depression in the relationship between physical activity and sleep quality: A serial multiple mediation model
Su, Y., Wang, S., Zheng, H., Tan, W., Li, X., Huang, Z., Hou, C., & Jia, F. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.047 · Cited by 47 · see citing works
Efficacy of an Interdisciplinary Intensive Outpatient Program in Treating Combat-Related Traumatic Brain Injury and Psychological Health Conditions
DeGraba, T. J., Williams, K., Koffman, R. L., Bell, J. L., Pettit, W., Kelly, J. P., Dittmer, T. A., Nussbaum, G. F., Grammer, G. G., Bleiberg, J., et al. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2020.580182 · Cited by 50 · see citing works
Evaluating the Clinical Feasibility of an Artificial Intelligence–Powered, Web-Based Clinical Decision Support System for the Treatment of Depression in Adults: Longitudinal Feasibility Study
Popescu, C., Golden, G. M., Benrimoh, D. A., Tanguay-Sela, M., Slowey, D., Lundrigan, E., Williams, J. D., Desormeau, B., Kardani, D., Pérez, T., et al. (2021) · JMIR Formative Research · doi:10.2196/31862 · Cited by 44 · see citing works
“Patients identified other clinical comorbidities, such as migraines (2/14, 14% of patients) and anxiety disorders (7/14, 50% of patients), which are described in detail in Multimedia Appendix 1 [10,11,20,25-32], Table S2.”
Background
Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial
Roy, A., Hoge, E. A., Abrante, P., Druker, S., Liu, T., & Brewer, J. A. (2021) · Journal of Medical Internet Research · doi:10.2196/26987 · Cited by 41 · see citing works
Investigating the potential risk of cadmium exposure on seizure severity and anxiety-like behaviors through the ferroptosis pathway in epileptic mice: An integrated multi-omics approach
Chang, Y., Jiang, X., Dou, J., Xie, R., Zhao, W., Cao, Y., Gao, J., Yao, F., Wu, D., Mei, H., et al. (2024) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2024.135814 · Cited by 37 · see citing works
A case series of group-based ketamine-assisted psychotherapy for patients in residential treatment for eating disorders with comorbid depression and anxiety disorders
Robison, R., Lafrance, A., Brendle, M., Smith, M., Moore, C., Ahuja, S., Richards, S., Hawkins, N., & Strahan, E. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00588-9 · Cited by 36 · see citing works
“The minimal clinically significant change on the GAD-7 was defined as a 4-point change [35].”
Method
Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study
Costa, F., Janela, D., Molinos, M., Lains, J., Francisco, G. E., Bento, V., & Dias Correia, F. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04891-5 · Cited by 35 · see citing works
Anxiety level among students of different college and universities in India during lock down in connection to the COVID-19 pandemic
Biswas, S., & Biswas, A. (2021) · Journal of Public Health · doi:10.1007/s10389-020-01431-8 · Cited by 35 · see citing works
Sensitivity to change and minimal clinically important difference of Edinburgh postnatal depression scale
Mao, F., Sun, Y., Wang, J., Huang, Y., Lu, Y., & Cao, F. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102873 · Cited by 36 · see citing works
Persistence rate of DSM-5 somatic symptom disorder: 4-year follow-up in patients from a psychosomatic outpatient clinic
Behm, A. C., Hüsing, P., Löwe, B., & Toussaint, A. C. (2021) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2021.152265 · Cited by 34 · see citing works
Self-citation
Self-management program versus usual care for community-dwelling older adults with multimorbidity: A pragmatic randomized controlled trial in Ontario, Canada
Fisher, K., Markle‐Reid, M., Ploeg, J., Bartholomew, A., Griffith, L. E., Gafni, A., Thabane, L., & Yous, M. (2020) · Journal of Comorbidity · doi:10.1177/2235042x20963390 · Cited by 33 · see citing works
Delivery of a Mental Health Intervention for Chronic Pain Through an Artificial Intelligence–Enabled App (Wysa): Protocol for a Prospective Pilot Study
Gupta, M., Malik, T., & Sinha, C. (2022) · JMIR Research Protocols · doi:10.2196/36910 · Cited by 34 · see citing works
“Clinically meaningful effect size is defined as at least 4.0 points for the GAD-7 [78].”
BackgroundInfluential
Development of health care workers' mental health during the SARS-CoV-2 pandemic in Switzerland: two cross-sectional studies
Spiller, T. R., Méan, M., Ernst, J., Sazpinar, O., Gehrke, S., Paolercio, F., Petry, H., Pfaltz, M. C., Morina, N., Aebischer, O., et al. (2020) · Psychological Medicine · doi:10.1017/s0033291720003128 · Cited by 31 · see citing works
“The minimal clinically important difference was defined as four points for the GAD-7 (Toussaint et al., 2020) and as five points for the PHQ-9 (Löwe, Unützer, Callahan, Perkins, & Kroenke, 2004).”
MethodInfluential
Effectiveness of a Videoconferencing-Delivered Psychological Intervention for Mental Health Problems during COVID-19: A Proof-of-Concept Randomized Clinical Trial
Bryant, R. A., Dawson, K. S., Keyan, D., Azevedo, S., Yadav, S., Tran, J., Rawson, N., & Harvey, S. B. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000520283 · Cited by 31 · see citing works
Improving sleep after stroke: A randomised controlled trial of digital cognitive behavioural therapy for insomnia
Fleming, M., Smejka, T., Macey, E., Luengo-Fernandez, R., Henry, A., Robinson, B., Kyle, S., Espie, C., & Johansen-Berg, H. (2023) · medRxiv · doi:10.1111/jsr.13971 · Cited by 32 · see citing works
“Mean (standard deviation) days between assessments did not differ between groups TABLE 2 ITT analysis of primary outcome (SCI-8 post-intervention) follow-up (PHQ-9: 32% versus 15%, χ 2 [1] = 2.73, p = 0.099; GAD-7: 35% versus 15%, χ 2 [1] = 3.588, p = 0.058).”
BackgroundInfluential
Effects of a Self-Guided Transdiagnostic Smartphone App on Patient Empowerment and Mental Health: Randomized Controlled Trial
Kerber, A., Beintner, I., Burchert, S., & Knaevelsrud, C. (2023) · JMIR Mental Health · doi:10.2196/45068 · Cited by 32 · see citing works
Internet-delivered cognitive behavior therapy versus treatment as usual for anxiety and depression among Latin American university students: A randomized clinical trial.
Benjet, C. L., Albor, Y., Alvis–Barranco, L., Contreras‐Ibáñez, C. C., Montoya, G. P. C., Cudris–Torres, L., González, N., Morelos, J. C., Gutiérrez–García, R. A., Medina‐Mora, M. E., et al. (2023) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000846 · Cited by 30 · see citing works
Combining Artificial Intelligence and Human Support in Mental Health: Digital Intervention With Comparable Effectiveness to Human-Delivered Care
Palmer, C. E., Marshall, E., Millgate, E., Warren, G., Ewbank, M., Cooper, E., Lawes, S., Bouazzaoui, M., Smith, A., Hutchins-Joss, C., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/69351 · Cited by 42 · see citing works
“The threshold for a clinically meaningful reduction in symptoms was defined as a change greater than the reliable change index of the GAD-7 scale (minimum of a 4-point reduction) [54].”
Arts on prescription: observed changes in anxiety, depression, and well-being across referral cycles
Sumner, R. C., Crone, D., Hughes, S., & James, D. V. B. (2021) · Public Health · doi:10.1016/j.puhe.2020.12.008 · Cited by 30 · see citing works
Building Emotional Awareness and Mental Health (BEAM): A Pilot Randomized Controlled Trial of an App-Based Program for Mothers of Toddlers
MacKinnon, A., Simpson, K. M., Salisbury, M. R., Bobula, J., Penner-Goeke, L., Berard, L., Rioux, C., Giesbrecht, G., Giuliano, R. J., Lebel, C., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.880972 · Cited by 24 · see citing works
“Anxiety was measured using the 7-item Generalized Anxiety Disorder scale (GAD7), where scores ≥10 indicate clinically significant symptoms (53), and a 4 point reduction represents clinically significant change (54).”
Method
Network structure of mobile phone addiction and anxiety symptoms among rural Chinese adolescents
Wang, J., Luo, Y., Yan, N., Wang, Y., Shiferaw, B. D., Tang, J., Pei, Y., Chen, Q., Zhu, Y., & Wang, W. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04971-x · Cited by 29 · see citing works
“Abbreviations MPAI Mobile Phone Addiction Index scale GAD-7 The Chinese version of the seven-item Generalized Anxiety Inventory PSQI Pittsburgh Sleep Quality Index scale SD Standard Deviation Supplementary Information The online version contains supplementary material available at https://doi. org/10.1186/s12888-023-0…”
MethodInfluential
Generalized Anxiety Disorder 7-Item (GAD-7) Scores in Medically Authorized Cannabis Patients—Ontario and Alberta, Canada
Lee, C., Round, J. M., Hanlon, J. G., Hyshka, E., Dyck, J. R. B., & Eurich, D. T. (2021) · The Canadian Journal of Psychiatry · doi:10.1177/07067437211043393 · Cited by 27 · see citing works
In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial
Lieshout, R. J. V., Layton, H., Savoy, C. D., Xie, F., Brown, J. S. L., Huh, K., Bieling, P., Streiner, D. L., Ferro, M. A., & Haber, E. (2023) · Psychological Medicine · doi:10.1017/s0033291723000454 · Cited by 27 · see citing works
“In accordance with previous research, ⩾ 4 point change in GAD-7 score was defined as clinically significant (Toussaint et al., 2020).”
Method
Psychosocial Consequences of Hand Eczema—A Prospective Cross-Sectional Study
Zalewski, A., Krajewski, P. K., & Szepietowski, J. C. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12175741 · Cited by 26 · see citing works
The Differential Role of Coping, Physical Activity, and Mindfulness in College Student Adjustment
Moeller, R. W., Seehuus, M., Simonds, J., Lorton, E., Randle, T. S., Richter, C., & Peisch, V. D. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01858 · Cited by 26 · see citing works
Stellate Ganglion Block Reduces Anxiety Symptoms by Half: A Case Series of 285 Patients
Lynch, J. H., Mulvaney, S. W., Bryan, C. J., & Hernandez, D. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13060958 · Cited by 25 · see citing works
“The MCID was calculated using a distribution-based approach [36], with GAD-7 change scores ≥ 4—approximately one standard deviation of the baseline mean score—set as the MCID threshold [37].”
Method
The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress
Yao, K., Chen, P., Zhou, H., Ruan, J., Chen, D., Yang, X., & Zhou, Y. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05348-w · Cited by 25 · see citing works
“The degree of anxiety was assessed by the Chinese version of the 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) [46, 47].”
Method
Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors
Cox, C. E., Gallis, J. A., Olsen, M. K., Porter, L. S., Gremore, T. M., Greeson, J. M., Morris, C. D., Moss, M., & Hough, C. L. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.0823 · Cited by 26 · see citing works
Digital phenotyping data and anomaly detection methods to assess changes in mood and anxiety symptoms across a transdiagnostic clinical sample
Cohen, A., Naslund, J. A., Lane, E., Bhan, A., Rozatkar, A. R., Mehta, U. M., Vaidyam, A. N., Byun, A. J. S., Barnett, I., & Torous, J. B. (2024) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13712 · Cited by 25 · see citing works
“30 Finally, our results provide estimates of the sample size necessary to validate these results in future studies.”
Safety and reactogenicity of a controlled human infection model of sand fly-transmitted cutaneous leishmaniasis
Parkash, V., Ashwin, H. M., Dey, S., Sádlová, J., Vojtková, B., Bocxlaer, K. V., Wiggins, R. C., David, T., Dey, N. S., Jaffe, C. L., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-03146-9 · Cited by 25 · see citing works
The Effects of Coronavirus Disease 2019 Outbreak on Medical Students
Bilgi, K., Aytaş, G., Karatoprak, U., Kazancıoğlu, R., & Özçelik, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.637946 · Cited by 25 · see citing works
Explanatory Model of Perceived Stress in the General Population: A Cross-Sectional Study in Peru During the COVID-19 Context
Carbajal, A. B., Navarro‐Flores, A., & Villarreal‐Zegarra, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.673945 · Cited by 25 · see citing works
“Additionally, according to a survey using the COVISTRESS questionnaire, assessed in 67 countries of the five continents, the selfreported symptoms of depression, anxiety and stress increased by 21.62, 16.71, and 21.8%, respectively (Ugbolue et al., 2020).”
MethodInfluential
Medical cannabis use in Canada and its impact on anxiety and depression: A retrospective study
Sachedina, F., Chan, C., Damji, R. S., & de Sanctis, O. J. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114573 · Cited by 25 · see citing works
Mental and physical training with meditation and aerobic exercise improved mental health and well-being in teachers during the COVID-19 pandemic
Demmin, D. L., Silverstein, S. M., & Shors, T. J. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.847301 · Cited by 24 · see citing works
“Score changes of four points or more on the GAD-7 are considered clinically significant (Toussaint et al., 2020).”
Background
Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial
Zhang, H., Zhang, X., Jiang, X., Dai, R., Zhao, N., Pan, W., Guo, J., Fan, J., & Bao, S. (2024) · Trials · doi:10.1186/s13063-024-08139-0 · Cited by 25 · see citing works
“We selected the PHQ-9 depression and GAD-7 anxiety scales because they are believed to possess high reliability and validity and are widely used internationally as generic questionnaires for depression [25] and anxiety [26].”
Method
Depression and anxiety in people with cognitive impairment and dementia during the COVID-19 pandemic: Analysis of the English Longitudinal Study of Ageing
Beach, B., Steptoe, A., & Zaninotto, P. (2023) · PLoS Medicine · doi:10.1371/journal.pmed.1004162 · Cited by 24 · see citing works
Stress-induced red nucleus attenuation induces anxiety-like behavior and lymph node CCL5 secretion
Shi, D., Zhang, Y.-D., Zhang, S., Liao, B.-B., Chu, M., Su, S., Zhuo, K., Hu, H., Zhang, C., & Wang, Z. (2023) · Nature Communications · doi:10.1038/s41467-023-42814-1 · Cited by 22 · see citing works
The impact of asthma on mental health and wellbeing during COVID-19 lockdown
Higbee, D., Nava, G. W., Kwong, A. S. F., Dodd, J. W., & Granell, R. (2021) · European Respiratory Journal · doi:10.1183/13993003.04497-2020 · Cited by 23 · see citing works
Relationship between working stress and anxiety of medical workers in the COVID-19 situation: A moderated mediation model
Hou, Y., Hou, W., Zhang, Y., Liu, W., & Chen, A. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.072 · Cited by 23 · see citing works
Targets and study design for symptom-focused trials aimed at patients with cirrhosis: An expert consensus
Patel, A., Tapper, E. B., Kanwal, F., Woodrell, C. D., Hansen, L., Lai, J. C., Rogal, S. S., McDermott, C. L., Rakoski, M. O., & Ufere, N. N. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000135 · Cited by 24 · see citing works
“— Generalized Anxiety Disorder-7 (GAD-7)[84] Observational[81] MCID: 4 points (out of 21) [261 patients with chronic depression][85]”
Background
How stroke-related dysphagia relates to quality of life: the mediating role of nutritional status and psychological disorders, and the moderating effect of enteral nutrition mode
Zeng, H., Zeng, X., Xiong, N., Wang, L., Yang, Y., Wang, L., Li, H., & Zhao, W. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1339694 · Cited by 23 · see citing works
Randomized controlled study of a digital data driven intervention for depressive and generalized anxiety symptoms
Fatouros, P., Tsirmpas, C., Andrikopoulos, D., Kaplow, S., Kontoangelos, K. A., & Papageorgiou, C. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01511-7 · Cited by 27 · see citing works
“Finally, minimal clinically important differences(MCID)werede ﬁ nedaschangesofatleast5pointsforthePHQ-9 scores 101 and at least 4 points for the GAD-7 scores 102 .”
Factors Associated With Highest Symptoms of Anxiety During COVID-19: Cross-Cultural Study of 23 Countries
Burkova, V. N., Butovskaya, M., Randall, A. K., Fedenok, J. N., Ahmadi, K., AlGhraibeh, A. M. A., Allami, F. B. M., Alpaslan, F. S., Al-Zu’bi, M. A. A., Al-Mseidin, K. I., et al. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.805586 · Cited by 24 · see citing works
Demographic and clinical characteristics associated with anxiety and depressive symptom outcomes in users of a digital mental health intervention incorporating a relational agent
Chiauzzi, E. J., Williams, A. A. A., Mariano, T. Y., Pajarito, S., Robinson, A. H., Kirvin-Quamme, A., & Forman‐Hoffman, V. L. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05532-6 · Cited by 22 · see citing works
“This is noteworthy given that these outcomes were two and three points greater, respectively, than the typically accepted change score cutoff of five and four points to define a clinically significant response on the PHQ-8 and GAD-7 measures, respectively [49, 50].”
The impact of Stress Management and Resilience Training (SMART) on academic physicians during the implementation of a new Health Information System: An exploratory randomized controlled trial
Spilg, E. G., Kuk, H., Ananny, L., McNeill, K., LeBlanc, V., Bauer, B. A., Sood, A., & Wells, P. S. (2022) · PLOS ONE · doi:10.1371/journal.pone.0267240 · Cited by 21 · see citing works
The psychological impacts of COVID-19: a study of frontline physicians and nurses in the Arab world
Mahyijari, N., Badahdah, A. M., & Khamis, F. A. (2020) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2020.119 · Cited by 20 · see citing works
“Generalized anxiety disorder-7 scale (GAD-7) This is one of the most used scales to gauge anxiety in both research and clinical settings (Toussaint et al., 2020).”
Systematic review with meta‐analysis: Stress‐management interventions for patients with irritable bowel syndrome
Horn, A., Stangl, S., Parisi, S., Bauer, N., Roll, J., Löffler, C., Gágyor, I., Haas, K., Heuschmann, P. U., Langhorst, J., et al. (2023) · Stress and Health · doi:10.1002/smi.3226 · Cited by 21 · see citing works
Anxiety and depression in Dutch patients with primary ciliary dyskinesia and their caregivers: associations with health-related quality of life
Verkleij, M., Appelman, I., Altenburg, J., Twisk, J. W. R., Quittner, A. L., & Haarman, E. G. (2021) · ERJ Open Research · doi:10.1183/23120541.00274-2021 · Cited by 21 · see citing works
Using a Brief Mental Imagery Competing Task to Reduce the Number of Intrusive Memories: Exploratory Case Series With Trauma-Exposed Women
Þórarinsdóttir, K., Holmes, E. A., Hardarson, J., Stephenssen, E. S., Jonasdottir, M. H., Kanstrup, M., Singh, L., Hauksdóttir, A., Halldorsdottir, T., Guðmundsdóttir, B., et al. (2022) · JMIR Formative Research · doi:10.2196/37382 · Cited by 17 · see citing works
“A 4-point change on the GAD-7 is considered clinically significant [33].”
Background
Impact of pain, fatigue and bowel incontinence on the quality of life of people living with inflammatory bowel disease: A UK cross‐sectional survey
Roukas, C., Miller, L., Büttner, F., Hamborg, T., Stagg, I., Hart, A., Gordeev, V. S., Lindsay, J. O., Norton, C. S., & Mihaylova, B. (2024) · United European Gastroenterology Journal · doi:10.1002/ueg2.12668 · Cited by 20 · see citing works
“16,17”
The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review
Verma, R., Kilgour, H. M., & Haase, K. R. (2022) · Current Oncology · doi:10.3390/curroncol29020053 · Cited by 19 · see citing works
“This change met the level of minimal clinical important difference (MCID), which is estimated at 4 points on the GAD-7 total score [30].”
Background
Comparative effectiveness of remote digital gamified and group CBT skills training interventions for anxiety and depression among college students: Results of a three-arm randomised controlled trial
Bantjes, J. R., Hunt, X., Cuijpers, P. J., Kazdin, A. E., Kennedy, C. J., Luedtke, A. R., Malenica, I., Petukhova, M. V., Sampson, N. A., Zainal, N. H., et al. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104554 · Cited by 21 · see citing works
Does m-health-based exercise (guidance plus education) improve efficacy in patients with chronic low-back pain? A preliminary report on the intervention’s significance
Zheng, F., Liu, S., Zhang, S., Yu, Q., Lo, W. L. A., Li, T., & Wang, C. (2022) · Trials · doi:10.1186/s13063-022-06116-z · Cited by 19 · see citing works
Associations of Ultra-Processed Food Intake and Its Circulating Metabolomic Signature with Mental Disorders in Middle-Aged and Older Adults
Yuan, S., Zhu, T., Gu, J., Li, H., Sun, J., Deng, X., & Ran, J. (2025) · Nutrients · doi:10.3390/nu17091582 · Cited by 18 · see citing works
“Each item was rated on a 4-point Likert scale ranging from 0 (“not at all”) to 3 (“nearly every day”) [25,26].”
Psychometric Evidence of the 7-Item Generalized Anxiety Disorder Questionnaire in Brazil
Monteiro, R. P., Nascimento, B. D. S., Monteiro, T. M. C., da Silva, P. D. G., & Ferreira, A. J. C. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00423-9 · Cited by 19 · see citing works
Effects of therapeutic exercise and aerobic exercise programmes on pain, anxiety and oral health‐related quality of life in patients with temporomandibular disorders
Moleirinho-Alves, P., Almeida, A., Exposto, F. G., Oliveira, R., & Pezarat‐Correia, P. (2021) · Journal of Oral Rehabilitation · doi:10.1111/joor.13239 · Cited by 18 · see citing works
Specifying the Efficacy of Digital Therapeutic Tools for Depression and Anxiety: Retrospective, 2-Cohort, Real-World Analysis
(2023) · doi:10.2196/47350 · Cited by 18 · see citing works
“%) of the users showed a reduction of ≥ 5 points (4 points is generally considered clinically significant [76]) in their anxiety levels.”
A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance
Murphy, M., Erridge, S., Holvey, C., Coomber, R., Rucker, J., & Sodergren, M. H. (2023) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12407 · Cited by 17 · see citing works
“65,66 The SQS scale is a rapid self-reported assessment of sleep quality.”
Background
Pet Attachment and Anxiety and Depression in Middle-Aged and Older Women
Żebrowska, M., Strohmaier, S., Huttenhower, C., Eliassen, A. H., Zeleznik, O. A., Westgarth, C., Huang, T., Laden, F., Hart, J. E., ROSNER, B. A., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.24810 · Cited by 18 · see citing works
Altered electroencephalography-based source functional connectivity in drug-free patients with major depressive disorder
Chu, C., Lin, Y., Huang, C. C., Chung, Y., Park, S. Y., Chang, W., Chang, C.-C., & Chang, H. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.10.087 · Cited by 17 · see citing works
Association Between Care Utilization and Anxiety Outcomes in an On-Demand Mental Health System: Retrospective Observational Study
Kunkle, S., Yip, M., Hunt, J. B., Watson, Ξ., Udall, D., Areán, P. A., Nierenberg, A. A., & Naslund, J. A. (2020) · JMIR Formative Research · doi:10.2196/24662 · Cited by 17 · see citing works
“As a secondary analysis for users who screened positive at follow-up and completed a full GAD-7 survey, we also looked at a clinically significant reduction in score, defined as a score reduction of >5 points [26-28].”
Background
Comparison of adverse childhood experience analytic approaches and associations with emotional and behavioral problems: A nationwide study among Chinese middle school students
Xiao, W., Xu, H., Yu, W., Li, S., Li, R., Jin, Z., Tao, F., & Wan, Y. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.01.060 · Cited by 17 · see citing works
Mindfulness Applications: Can They Serve as a Stress, Anxiety, and Burnout Reduction Tool in Orthopaedic Surgery Training? A Randomized Control Trial
Boden, L. M., Rodriguez, C., Kelly, J. D., Khalsa, A. S., & Casper, D. S. (2023) · JBJS Open Access · doi:10.2106/jbjs.oa.22.00114 · Cited by 16 · see citing works
Economic Insecurities and Mental Health Among Low-Income Pregnant People in the Central Valley Region of California
Zahid, N., Blebu, B. E., Felder, J. N., McCulloch, C. E., Chambers, B. D., Curry, V. C., Carraway, K., León-Martínez, D., Coleman‐Phox, K., Kuppermann, M., et al. (2025) · Women s Health Issues · doi:10.1016/j.whi.2025.01.006 · Cited by 16 · see citing works
Vagus nerve stimulation therapy for treatment-resistant PTSD
Powers, M. B., Hays, S. A., Rosenfield, D., Al, P., Gallaway, H. L., Chauvette, G. V., Smits, J. A. J., Warren, A. M., Douglas, M., Naftalis, R. C., et al. (2025) · Brain stimulation · doi:10.1016/j.brs.2025.03.007 · Cited by 16 · see citing works
“The Generalized Anxiety Disorder screener is a short questionnaire used to evaluate anxiety-related symptoms [36].”

Advances in Thoracic Surgery
Davison, R. (1939) · Diseases of the Chest · doi:10.1378/chest.5.5.21
Beyond generalized anxiety disorder: Psychometric properties of the GAD-7 in a heterogeneous psychiatric sample
Beard, C., & Björgvinsson, T. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.002 · Cited by 360 · see citing works
How much change is enough? Evidence from a longitudinal study on depression in UK primary care
Kounali, D., Button, K. S., Lewis, G., Gilbody, S., Kessler, D., Araya, R., Duffy, L., Lanham, P., Peters, T. J., Wiles, N., et al. (2022) · Psychological Medicine · doi:10.1017/s0033291720003700 · Cited by 164 · see citing works
Validity of the Generalized Anxiety Disorder‐7 Scale in an Acute Psychiatric Sample
Kertz, S., Bigda‐Peyton, J., & Bjorgvinsson, T. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1802 · Cited by 271 · see citing works
Generalized anxiety disorder severity scale (GADSS): a preliminary validation study
Shear, K. M., Belnap, B. H., Mazumdar, S., Houck, P. R., & Rollman, B. L. (2006) · Depression and Anxiety · doi:10.1002/da.20149 · Cited by 73 · see citing works

Authors: Toussaint, A., Hüsing, P., Gumz, A., Wingenfeld, K., Härter, M., Schramm, E., & Löwe, B.
Affiliations: University Medical Center Hamburg-Eppendorf (DE)
Charité – Universitätsmedizin Berlin (DE)
University of Freiburg (DE)
Corresponding author: Toussaint, Anne
ORCID: Toussaint, Anne
Hüsing, Paul
Gumz, Antje
Wingenfeld, Katja
Härter, Martin
Schramm, Elisabeth
Löwe, Bernd
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2020-03
Volume: 265
Pages: 395-401
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2020.01.032
OpenAlex: W3000661394
Cited by: 641
References: 68
Citations by year: 2026: 134 · 2025: 138 · 2024: 113 · 2023: 99 · 2022: 68 · 2021: 59 · 2020: 30
FWCI: 61.87
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: GAD-7, Generalized Anxiety Disorder Scale, anxiety symptoms, chronic depression, sensitivity to change, minimal clinically important difference, standardized response mean, treatment response monitoring, Hamilton Depression Rating Scale
MeSH terms: Minimal Clinically Important Difference, Patient Health Questionnaire, Anxiety Disorders, Depression, Humans, Treatment Outcome

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Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)

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