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

The DOI matches its Crossref record; 68 of the 68 references it cites were found in a registry or an index.

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

Open this paper in CoChat — free account

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.

Integrity signals

Registry

Crossref · 10.1016/j.jad.2020.01.032

Cites

68 of 68 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,603
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,417
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Self-citation
Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391
Diagnostic and Statistical Manual of Mental Disorders(DSM)
Leong, F. T. L. (2008) · Sage eBooks · doi:10.4135/9781412963978.n182 · Cited by 10,861
Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs
Lakens, D. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00863 · Cited by 10,303
Validation and Utility of a Self-report Version of PRIME-MD<SUBTITLE>The PHQ Primary Care Study</SUBTITLE>
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
Development of a Rating Scale for Primary Depressive Illness
Hamilton, M. (1967) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1967.tb00530.x · Cited by 8,410
The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS-R)
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-5-200703060-00004 · Cited by 4,741
Self-citation

Flagged first, then by citations

Show all 68 references

Research works printed but not linked: 2

First, 2002, Structured clinical interview for DSM-IV-TR Axis I disorders, research version, patient edition (SCID-I/P)
Schuck, 2000, Z. Med. Psychol, 9, 125

Sorted by citations

Items 501–600 of 638

Concussion Outcomes 3 Months after an Intervention for Young Adults with Co-Occurring Anxiety: A Randomized Controlled Trial
Levey, N., Bakhshaie, J., Vranceanu, A., & Greenberg, J. (2025) · Journal of Integrative and Complementary Medicine · doi:10.1177/27683605251363177
From Rhythm to Relief: Heart Rate Variability as a Window into Anhedonia Response During Agomelatine Treatment in Major Depressive Disorder
Ma, C.-C., Yang, C.-Y., Chang, W., Sack, A. T., Chang, C.-C., & Chang, H. (2025) · Medicina · doi:10.3390/medicina61091522
“The self-reported overall severity of depression and anxiety was assessed using the Patient Health Questionnaire (PHQ-9) [32], and Generalized Anxiety Disorder 7 (GAD-7) [33], respectively.”
Gaze-Contingent Musical Attentional Bias Modification: Exploring Feasibility and Clinically-Relevant Changes in Mood
Greenaway, A.-M., Hwang, F., Nasuto, S. J., & Ho, A. K. (2025) · Psychological Reports · doi:10.1177/00332941251370235
UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Complex Regional Pain Syndrome
Evans, L., Erridge, S., Varadpande, M., Aggarwal, A., Cowley, I., Clarke, E., McLachlan, K., Coomber, R., Rucker, J., Platt, M. W., et al. (2025) · Brain and Behavior · doi:10.1002/brb3.70823
Program Delivery and Change in Patient-Reported Outcomes of an Age-Specific Rehabilitation Program for Young Adult Cancer Survivors: A Feasibility Study
Aagesen, M., Pilegaard, M. S., Ipsen, K., Jørgensen, D. S., Hauken, M. A., & la Cour, K. (2025) · Journal of Adolescent and Young Adult Oncology · doi:10.1177/21565333251372461
A Mixed-Methods Analysis of Response to NOVELA Among Hospice Family Caregivers
Cruz-Oliver, D. M., Blinka, M. D., Milner, G. E., Nelson, K. E., Bugayong, M. T., Durkin, N., Gallo, J. J., Oliver, D. P., & Saylor, M. A. (2025) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091251371149
“11,31 Lastly, the sample was largely homogenous, comprised of White females, which was a recruitment limitation and decreased our ability to generalize results.”
Prevalence and associated risk factors of generalised anxiety disorders in children with seizure disorders in the rural population of northern India – an observational study
Kumar, D., Kumar, D., Sharma, N., Kumar, R., Rastogi, D., & Alim, M. (2025) · Tropical Doctor · doi:10.1177/00494755251376420
“18 22 In our study, signi ﬁ cant anxiety in children with epilepsy was found in 8%, implying epilepsy may not be a contributory factor.”
A reason for caution: the identification of sudden gains may depend on the outcome measure used
Correa, A. B., Bisby, M. A., & Dear, B. F. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2556723
“A large meta-analysis (Plummer et al., 2016) identified a score of � 8 to be a reasonable cutoff for clinical levels of anxiety, and a change of 4-points has been identified as clinically meaningful (Toussaint et al., 2020).”
Associations between pre-pandemic housing insecurity and reports of anxiety and depression in the early months of the COVID-19 pandemic: an analysis of the All of Us Research Program cohort
Routhier, G., Titus, A. R., Xin, Y., Cui, B., & Cook, S. (2025) · BMC Public Health · doi:10.1186/s12889-025-24535-w
“The GAD-7 is a validated self-report screening tool that measures symptoms of anxiety, with scores ranging from 0 to 21 [21].”
Reducing Intrusive Trauma Memories Using a Brief Mental Imagery Competing Task Intervention: Case Series of Trauma-Exposed Women in Iceland
Þórarinsdóttir, K., Holmes, E. A., Hardarson, J., Ágústsdóttir, F., Kanstrup, M., Singh, L., Hauksdóttir, A., Halldorsdottir, T., Guðmundsdóttir, B., Thordardottir, E. B., et al. (2025) · JMIR Formative Research · doi:10.2196/72748
“A 4-point change on the GAD-7 from pre-to posttreatment is considered clinically significant [42].”
Association of prior history of suicide attempt and disease severity and subsequent suicidal acts among patients with psychiatric disorders in North China: a multicentre prospective study protocol
Wu, J., Min, J., Luo, Y., Li, P., Li, L., Ge, Y., Yun, Y., Lei, C., Wang, Q., Zhou, F., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-101561
“Generalised Anxiety Scale (GAD-7) 33 : This is used to assess the severity of anxiety symptoms in the 2 weeks preceding the patient interview; each item is scored on a 4-point scale from ‘not at all’ to ‘almost every day’.”
Influential
Examining the effectiveness and equity of fully virtual therapy for college students
Loren, D. M., Reuter, T., Palko, A., Bickham, N., Klein, K. V., & Booth, R. (2025) · Journal of American College Health · doi:10.1080/07448481.2025.2563025 · Cited by 2
“We used standard clinical assessments (GAD-7, PHQ-9) to monitor patients’ self-reported anxiety and depression symptoms.”
Effect of COVID-19 Pandemic on Mental Health Status of Different Age Groups in a Sample Population in Aruba
Davies, L., Dusic, A., Adam, A. E., Khan, K. W., Dol, D., Leonardo, X., Ram, K., Tromp, V., Acosta, J., Ahmed, F., et al. (2025) · Open Journal of Internal Medicine · doi:10.4236/ojim.2025.154026
Synchronous tele‐interpersonal psychotherapy versus tele‐cognitive behavioural therapy for adults: which works better? Results from a randomised clinical trial
Lucas, L. S., Borba, B. L. I., de Azevedo, B. M., Cagliari, A., Valim, A. R. D. M., Garcia, E. L., Areosa, S. V. C., Morelle, A. M., Damin, M. R. A., Stülp, S., et al. (2025) · General Psychiatry · doi:10.1136/gpsych-2025-102067 · Cited by 1
Analysis of clinical application value of miR-1284 in type 2 diabetes mellitus
Li, Y., Yang, Y., Ma, Y., & Yan, L. (2025) · Turkish Journal of Biochemistry · doi:10.1515/tjb-2025-0123
“After caring, the patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were used for scoring, with higher scores indicating more severe depression or anxiety [27, 28].”
EEG-Based Prediction of rTMS Treatment Response in Depression: Nonlinear Features and Machine Learning with Minimal ElectrodePreprint
Chang, C.-H., Sack, A. T., Chu, C., & Chang, H. (2025) · medRxiv · doi:10.1101/2025.10.30.25339032
“The self - reported overall severity of depression and anxiety was assessed using the Patient Health Questionnaire (PHQ - 9)(Chung et al., 2023), and Generalized Anxiety Disorder 7 (GAD - 7)(Toussaint et al., 2020), respectively.”
Effectiveness of a guided mobile app intervention for depression and anxiety in university students (PROMES-U study): protocol of a multicenter randomized controlled trial
Ballester, L., Gili, M., Roca, M., Forteza-Rey, I., Soto‐Sanz, V., Vilagut, G., Amigo, F., Moreno‐Küstner, B., Mortier, P., Piqueras, J. A., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-24752-3 · Cited by 2
“For GAD-7, 4 points were estimated as the minimal clinically important difference in longitudinal assessments and corresponding to two standard error of measurement [63].”
Home-based virtual reality scenic relaxation for patients with insomnia and anxiety: a single-arm feasibility and safety studyPreprint
Yanagi, N., Katsuta, N., Nojiri, S., Nara, T., Kumamaru, K. K., Takeshita, Y., & Tobita, M. (2025) · medRxiv · doi:10.1101/2025.11.06.25339711
Application of Narrative and AI-Assisted Follow-Up After Voluntary Medical Male Circumcision: Multicenter, Double-Blind, Prospective, Randomized Controlled Trial
Wang, L., Peng, Y., Zhang, G., Huang, Y., Yang, G., Yu, J., Xu, Q., Yu, J., Jin, J., Qiao, H., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/68573
“The GAD-7 scale consists of 7 items that assess the anxiety levels of participants over the past 2 weeks, with higher scores indicating greater anxiety (0 ‐ 21 points) [28,29].”
Digital tools for exposure and problem-solving in type 1 diabetes mellitus: a feasibility investigation
Kern, D., Ljótsson, B., Catrina, S., Lindefors, N., & Kraepelien, M. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2595107
Clinical Outcomes of a Trauma Rehabilitation Program for Patients After Work-Related Injury: A Retrospective Chart Review
Goozeé, S., Crane, J., Giertych, A., Maoz, I., Johnson, M., Luong, A., & Navani, A. H. (2025) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2025.2585259
“Total score ranges from 0 to 21, with 0–4 indicating minimal anxiety, 5–9 indicating mild anxiety, 10–14 indicating moderate anxiety, and 15–21 indicating severe anxiety (Toussaint et al., 2020).”
A prospective cohort study of prescription opioid use and change in generalized anxiety in non-cancer pain
Metivier, A., Chrusciel, T., Miller-Matero, L. R., Salas, J., Pappas, C., Secrest, S., Wilson, L., Lustman, P. J., Ahmedani, B. K., Carpenter, R. W., et al. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.11.010
Insomnia of students following the lifting of COVID-19 restrictions in China: Prevalence, influencing factors, and associations with depression, anxiety, and PTSD
Zhang, H., Li, Y., Wang, C., Liu, Y., Yang, Y., Zhou, L., Jin, H. M., Xiao, Y., Wen, Y., Ahmad, J., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1680558
Adapting WHO's Step‐By‐Step Digital Intervention for Anxiety and Depression for Delivery Via Radio: Development, Piloting and Mixed‐Methods Evaluation of the Lumuno Radio Campaign In Zambia
Clare, A., Mukumba, R., Mclaren, M., Dalal, N., Murray, J., Wayal, S., & Hollowell, J. (2025) · Mental Health Science · doi:10.1002/mhs2.70035
Residual Income and Mental Health: A Longitudinal Study
Korbel, V., & Škvrňák, M. (2025) · Social Indicators Research · doi:10.1007/s11205-025-03742-3
“The minimal clinically important difference (MCID) for depression and anxiety scales has been identified as approximately 3 to 5 points (Kroenke et al., 2001; Toussaint et al., 2020).”
Comparison of Jaw Function and Mental Health Between Patients With Anterior Disc Displacement With and Without Reduction
Yao, Y., Liu, S., Jin, L., Ye, J. L., Fang, Z. Y., Yang, Y., Xu, L., Cai, B., & Jiang, X. H. (2025) · Clinical and Experimental Dental Research · doi:10.1002/cre2.70261
“The total scores were graded as no anxiety (0–4 points), mild anxiety (5–9 points), moderate anxiety (10–14 points), or severe anxiety (15–21 points) (Toussaint et al. 2020).”
Development and Validation of Risk Assessment Models for Anxiety and Depression in Chinese Children with Childhood Household Dysfunction
Mao, P., Xia, J., Yang, J., Hou, X., Zou, Y., Liu, J., Cai, L., Tong, X., & He, W. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107842
Additional file 2 of Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults
Bakal, M., Ambriz, E., Ortiz-Pivaral, L., Kogut, K., Snell‐Rood, C., Rauch, S. A., Eskenazi, B., & Deardorff, J. (2024) · Figshare · doi:10.6084/m9.figshare.26755684
Additional file 2 of 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) · Figshare · doi:10.6084/m9.figshare.14391486
Additional file 2 of Design of and outcomes in a student-run free mental health clinic serving the uninsured in East Harlem
Powell, S. K., Saali, A., Frere, J. J., Magill, E. B., Krystal, H. L., Serafini, R. A., Sultana, S., Dale, B., Ali, M., Kumar, V., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20381875
Additional file 1 of Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults
Bakal, M., Ambriz, E., Ortiz-Pivaral, L., Kogut, K., Snell‐Rood, C., Rauch, S. A., Eskenazi, B., & Deardorff, J. (2024) · Figshare · doi:10.6084/m9.figshare.26755681
Additional file 1 of 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) · Figshare · doi:10.6084/m9.figshare.14391483
Association between physical fitness index and psychological symptoms in left-behind children: a cross-sectional study from East ChinaPreprint
Wen, Y., Xiong, L., Luo, S., Deng, G., Jiang, J., & Li, Y. (2024) · Research Square · doi:10.21203/rs.3.rs-4008731/v1
Additional file 1 of Design of and outcomes in a student-run free mental health clinic serving the uninsured in East Harlem
Powell, S. K., Saali, A., Frere, J. J., Magill, E. B., Krystal, H. L., Serafini, R. A., Sultana, S., Dale, B., Ali, M. O., Kumar, V., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20381872
Additional file 1 of Patient-reported outcomes in a pilot clinical trial of twice-weekly hemodialysis start with adjuvant pharmacotherapy and transition to thrice-weekly hemodialysis vs conventional hemodialysis
Murea, M., Highland, B. R., Yang, W. Z., Dressler, E. V. M., & Russell, G. B. (2022) · Figshare · doi:10.6084/m9.figshare.21220406
Additional file 2 of Patient-reported outcomes in a pilot clinical trial of twice-weekly hemodialysis start with adjuvant pharmacotherapy and transition to thrice-weekly hemodialysis vs conventional hemodialysis
Murea, M., Highland, B. R., Yang, W. Z., Dressler, E. V. M., & Russell, G. B. (2022) · Figshare · doi:10.6084/m9.figshare.21220409
Additional file 1 of 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) · Figshare · doi:10.6084/m9.figshare.23658111
Additional file 1 of Prevalence of pharmacological and non-pharmacological coping mechanisms for anxiety management during the COVID-19 pandemic: investigating the transition to online learning among medical students
Almarri, F. K., Alaseem, A. M., Alanazi, M. S., Alyahya, S., Alsanad, N. H., Alswayed, K. E., Alanazi, J., Alharby, T. N., & Alghamdi, S. A. (2022) · Figshare · doi:10.6084/m9.figshare.21557567
Additional file 1 of Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up
Mikkonen, J., Luomajoki, H., Airaksinen, O., Goubert, L., & Leinonen, V. (2023) · Figshare · doi:10.6084/m9.figshare.22774246
Additional file 1 of 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) · Figshare · doi:10.6084/m9.figshare.26674502
Additional file 3 of Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up
Mikkonen, J., Luomajoki, H., Airaksinen, O., Goubert, L., & Leinonen, V. (2023) · Figshare · doi:10.6084/m9.figshare.22774252
Additional file 1 of 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) · Figshare · doi:10.6084/m9.figshare.16880341
Additional file 2 of Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up
Mikkonen, J., Luomajoki, H., Airaksinen, O., Goubert, L., & Leinonen, V. (2023) · Figshare · doi:10.6084/m9.figshare.22774249
Association of accelerometer-measured step count and intensity with mental health: A prospective cohort study
Du, J., Wang, J., Zhang, L., Liu, M., Nie, Y., Zhang, W., He, Y., Wu, Q., Liu, Y., Ai, S., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120980
Effectiveness of Digital Health Interventions on Stress, Anxiety, and Depression in University Students: A Systematic Review and Meta-Analysis
Zhan, X., Zeng, J., Zhu, D., Chen, Y., Zhang, J., Li, S., & Huang, L. (2026) · Journal of Visualized Experiments · doi:10.3791/69949
Gaming‑Based Community Intervention for Loneliness in Adult Gamers: Longitudinal Observational Study
Neu, C., Hull, T. D., & Malgaroli, M. (2026) · JMIR Formative Research · doi:10.2196/82428
“The GAD-7 was also selected for its length, reliability, validity, and sensitivity to change [69].”
Comparative Efficacy of Pulmonary Rehabilitation in Patients With COPD, ILD, and Long COVID: Physical and Psychosocial Outcomes
Berkowitz, J. L., Lu, F. Q., DeAngelis, J., Simmons, J. M. D., & Wu, W.-C. (2026) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000997
Current situation and influencing factors of surgical fear in patients with retinal detachment complicated with lung malignant tumor
Wu, C., Haicui, S. H. E. N., Zhou, J., & Wang, J. (2026) · Psycho-Oncologie · doi:10.18282/po4128
Dyadic association between support persons’ attitudes towards medication for opioid use disorder and patients’ mental health outcomes
Moon, K. J., Burgette, L. F., Choi, J., Nameth, K., Shah, K., Watkins, K. E., & Osilla, K. C. (2026) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2026.113053
Underlying Mechanisms of the Treatment Efficacy of ( R, S )‐Ketamine for Post‐Traumatic Stress Disorder and Depression: A Review
Cutting, T., & Hartman, R. E. (2026) · Medicine Advances · doi:10.1002/med4.70051
“Treatment with ( R, S )‐ketamine occurred once per week, and study participants were evaluated after 2 and 4 weeks using the Patient Health Questionnaire‐9 [58] to measure depressive symptoms and the Generalized Anxiety Disorder 7‐item scale [59] to assess anxiety.”
Response to “Clinical relevance of venlafaxine ER for generalized anxiety disorder”
Otsubo, T., Watanabe, K., Inoue, T., Inagaki, A., Kikuchi, T., Nomoto, K., Higa, S., Asami, Y., Sun, B., & Marschall, K. (2026) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.70027
Acceptance and Commitment Therapy (ACT) for Comorbid Generalized Anxiety Disorder and Premenstrual Dysphoric Disorder: A Transdiagnostic Approach
Howard, L. R., Earleywine, M., DeCount, T., & Forsyth, J. P. (2026) · Clinical Case Studies · doi:10.1177/15346501261421541
“Her pre-treatment score of 15 decreased by 10 points, which is above the minimal clinically important difference (MCID) of 4 points (Toussaint et al., 2020).”
Update of the Novara Cohort Study (NCS): protocol evolution of a population-based longitudinal study on ageing in Northern Italy – cohort profile
Cracas, S. V., Garro, G., Venetucci, J., Martorana, M., Antona, A., Bettio, V., Rossato, D., Briacca, L., Viola, E., Caristia, S., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-109328
“22 The ability to deal with stressful situations was measured with the Perceived Stress Scale-10, 23 while coping strategies were evaluated using the 21-item Coping Inventory for Stressful Situations, which captures task-oriented, emotion-oriented and avoidance-oriented coping styles.”
Repeated Electrical Vestibular Nerve Stimulation Reduces Anxiety in People With Moderate-to-Severe Anxiety: A Randomized, Sham-Controlled Trial: The Modius Anxiety Study
Curry, G., Zhang, S.-D., McAnena, L. B., Price, R. K., & Sittlington, J. (2026) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2025.11.008
Psychological burden and its association with preferred form of psychological assistance of healthcare workers during the COVID-19 pandemic in China: a cross-sectional study
Zhang, L., Peng, Z., Cheng, P., Zheng, W., Xu, L., & Li, W. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-102149
A randomised controlled trial of Acceptance and Commitment Therapy plus usual care in comparison to usual care alone for reducing anxiety in older people with treatment-resistant generalised anxiety disorder (CONTACT-GAD): trial protocol
Gould, R. L., Callaghan, T., White, D., Wetherell, J. L., Bursnall, M., Bradburn, M., Wailoo, A., Serfaty, M. A., Graham, C. D., Howard, R. J., et al. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07094-6
“…of 0.37 SD is based on the fact that: a) improvements of 3–4 GAD-7 units are regarded as clinically important changes to individual patients [36– 39]; and b) a change of approximately 2 GAD-7 units (0.4 SD) would mean an additional 15% of people having a clinically important improvement of 3…”
Influential
Complementary Feeding Frequency and Maternal Health: Reducing Anxiety and Improving Sleep Through Biobehavioral Pathways
Shi, Y., Zeng, P., Fan, X., Wang, L., He, C., Zhou, Z., Deng, W., Guo, J., Zhang, Y., Luo, Y., et al. (2026) · Nature and Science of Sleep · doi:10.2147/nss.s571703
Clinically Meaningful Improvement in Depression and Anxiety Among Psychiatry Patients Within a Measurement-Based Care Digital Mental Health Intervention: A Retrospective Analysis of Real-World Data from Rula Health
McAlister, K. L., Baez, L. M., Newton, D. A., Seiniger, S., Woodhouse, A., & Huberty, J. (2026) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580261418135
“30 Symptoms of anxiety are assessed using the GAD-7, 31 a 7-item self-report measure of the severity of generalized anxiety symptoms over the last 2 weeks.”
Sleep Disturbances and Mental Health Outcomes in Chinese Youth Following COVID-19 Policy Changes
Caldwell, P. N., & Reynolds, B. S. (2021) · Journal of Medical Sciences and Interdisciplinary Research · doi:10.51847/zq17uchdr0
Abnormal baseline brain activity in migraine without aura with versus without patent foramen ovale: a resting-state functional magnetic resonance imaging study
Dai, C., Hu, Y., Huang, M., Liu, X., Tao, Z., Zhang, X., Li, X., Yang, X., 叶梦茜, Fu, F., et al. (2026) · Neuroradiology · doi:10.1007/s00234-026-03906-z
“Sleep quality and insomnia severity were subjectively assessed with Pittsburgh Sleep Quality Index (PSQI) [26 ], while depression and anxiety symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) [26 ]and the Generalized Anxiety Disorder-7 (GAD-7) [27 , 28 ], respectively.”
Cognitive bias modification for social anxiety: a living systematic review and network meta-analysis
Kennett, J., Chiocchia, V., Friedrich, C., Blackwell, S. E., Carlbring, P., Furukawa, T. A., Siafis, S., Money, C., Tonia, T., Wright, S. L., et al. (2026) · Wellcome Open Research · doi:10.12688/wellcomeopenres.25609.1
Changes in perceived cognitive functioning following a codesigned online group cognitive rehabilitation for prostate cancer survivors on androgen deprivation therapy: Series of single-case experimental designs
Pembroke, L., Sherman, K. A., Dhillon, H. M., Francis, H., Gillatt, D. A., & Gurney, H. (2026) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2026.2637569
Effectiveness of guided self-help, guided internet-delivered cognitive behavioral therapy, and face-to-face cognitive behavioral therapy for depression and anxiety: protocols of four parallel randomized controlled non-inferiority trials of the Finnish First-Line Therapies –Initiative (FLT-Step)
Helminen, E.-E., Saarni, S. E., Mikkonen, K., Mattila, M. K., Rosenström, T. H., Karukivi, M., Isometsä, E. T., Stenberg, J., Ekelund, J., & Saarni, S. I. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07962-w
“…proportion of patients in remission [32, 36], defined as scoring below the clinical cut-off ( 10 p in PHQ-9 or GAD-7 respectively), and those experiencing a clinically significant change in depression symptoms, indicated by a change of ≥ 5 [60] points on the PHQ-9 or ≥ 4 points on the GAD-7 [61].”
Intensity of physical activity, VO₂max, and mental health in women: Does motherhood matter?
Vallini, L., Souza, V. R. D. A., Vivan, L., de Lira, C. A. B., de Freitas, J. V. R., Costa, G. D. C. T., Vancini, R. L., Weiss, K., Rosemann, T. J., Knechtle, B., et al. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.106630
Neuroanatomical Substrates of emotional Dysregulation in Bulimia NervosaPreprint
Zhang, L., Zhao, X., Liu, L., Bao, W., Wang, M., Wang, Y., Hu, X., & Huang, X. (2026) · Research Square · doi:10.21203/rs.3.rs-9025261/v1
Feasibility of classic massage for Swedish nurses: a mixed methods pre-post-test design study
Westas, M., Ekström, L., Sandqvist, J. L., Wåhlin, C., Andersson, G., & Johansson, P. (2026) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-026-05356-9
“A 4-point reduction has been suggested as the threshold for minimum clinically important difference (MCID) [27].”
Impact and feasibility of online training for high intensity therapists treating clients with personality difficulties: a mixed method study
Eyles, E., Farr, M., Dunn, B. D., Redaniel, M. T., Warbrick, L. A., Kessler, D. S., Cooper, R., & Moran, P. (2026) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25100482
“(2) Anxiety symptoms (General Anxiety Disorder-7, GAD-7) (Toussaint et al ., 2020); higher scores (ranging between 0 and 21) indicate more severe anxiety.”
Outcomes following a physician-led CBT skills group for anxiety and depression in primary care: a longitudinal cohort study
Pawluk, A., Ward, G., & Niyyati, S. (2026) · BMC Family Practice · doi:10.21203/rs.3.rs-9034659/v1
Cannabis-based medicinal products for cancer pain: a two-year prospective analysis from the UK medical cannabis registry
Ukpeh, P., Erridge, S., Clarke, E., McLachlan, K., Coomber, R., Rucker, J., Platt, M. W., Khan, S. A., & Sodergren, M. H. (2026) · Progress in Palliative Care · doi:10.1080/09699260.2026.2650901
Screening Emotions in Adolescents Receiving Care at the Hospital for mild Traumatic Brain Injury (SEARCH-mTBI): protocol for a multicenter observational study
Nishijima, D. K., Kuppermann, N., Suskauer, S. J., Arbogast, K. B., Badawy, M. K., Casper, T. C., Cruz, A. T., Corwin, D. J., Johnson, T. J., Rosenthal, E. D., et al. (2026) · BMC Pediatrics · doi:10.1186/s12887-026-06788-5 · Cited by 3
“A change of 4 points on the GAD-7 is the minimal clinically important difference [34].”
UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Migraine
Hooper, L., Erridge, S., Clarke, E., McLachlan, K., Coomber, R., Iqbal, A., Rucker, J., Weatherall, M. W., & Sodergren, M. H. (2026) · Brain and Behavior · doi:10.1002/brb3.71323
“Scores are totalled as follows: 0–4: minimal anxiety, 5–9: mild anxiety, 10–14: moderate anxiety, 15–21: severe anxiety 0–21 4-point change (Toussaint et al. 2020 )”
The Preliminary Efficacy of an Equine-Assisted Social-Emotional Learning Program for Youth with Diminished Social-Emotional Competencies
Matlock, S., Birmingham, D., Merritt, T., Hess, A., Reega, S. J., & Peters, B. (2026) · Journal of Experiential Education · doi:10.1177/10538259261440175
“The GAD-7 has evidence of construct validity, excellent reliability, and is sensitive to change with intervention (Löwe et al., 2008; Williams, 2014a; Toussaint et al., 2020).”
Videoconferencing acceptance and commitment therapy for parents of children with special health care needs: A randomised controlled trial
Chong, Y. Y., Chan, J. K. F., Yau, P. T., Li, T. M. H., Fung, K. P., & Chien, W. T. (2026) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2026.105525
Rehabilitation of cognition and psychosocial well‐being in epilepsy: Results of a randomized waiting list‐controlled trial
Puteikis, K., Aukselė, G., Jakonienė, A., Jasionis, A., Wolf, P., & Mameniškienė, R. (2026) · Epilepsia · doi:10.1002/epi.70248
“However, the overall reduction in symptoms of anxiety did not constitute a clinically meaningful improvement (with the threshold set at a reduction by 3–4 points), 34,35 likely owing to low baseline GAD-7 scores.”
The impact of mentalization and psychological flexibility on college students’ mental health: A cross-sectional study
Li, X., Yang, X., & Wang, X. (2026) · Medicine · doi:10.1097/md.0000000000048387
“[23,24] The GAD-7 is a self-reported anxiety questionnaire consisting of 7 items.”
“Goodnight, Poor Sleep”: A randomized-controlled trial of a brief, peer-led, psychological sleep intervention for university students
Gillen, L., Nguyen, E. V., Dodd, S., Irving, T., Tan, A., Boyne, E., Hartung, K., Olaithe, M., Bucks, R. S., Ree, M. J., et al. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.105048
Effectiveness and Cost-Effectiveness of the Tankevirus and Grubl Mental Health Apps Compared With a Placebo App—Mental Health Intervention With Digital Applications (MIND-APP): Protocol for a Randomized Controlled Researcher-Blinded Trial
Rand, K., Menichetti, J., Wisløff, T. F., & Brorson, H. H. (2026) · JMIR Research Protocols · doi:10.2196/84096
Intranasal Ketamine for Existential Distress in Advanced Cancer
Aguiar, S., Makarious, M., Lipsitz, O., deVries, F. E., Doyle, Z., McIntyre, R. S., Rodin, G., Zimmermann, C., Mak, E., Hannon, B. L., et al. (2026) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2026.04.611 · Cited by 1
Associations of academic stress with anxiety and depressive symptoms: the mediating role of emotional eating
Ding, P., & Wang, J. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1826577
“Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7)(26), which evaluates the frequency of anxiety-related symptoms over the past 2 weeks, including nervousness, inability to control worry, excessive worry, diﬃculty relaxing, restlessness, irritability, and fear that something awf…”
Influential
Can the GAD-7 be used to create valid, reliable, feasible and actionable outcome-focused paediatric anxiety quality measures for use across specialty and paediatric treatment settings?
Mark, T. L., Saavedra, L. M., Kirsch, S., Pogue, Y. Z., Lynch, F. L., Koebnick, C., Morgan‐López, A. A., Yaros, A., & Juel, E. K. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-119157
“…both adult and adolescent populations 23 24 ; (2) it is responsive to change and thus can be used to measure progress in reducing anxiety symptoms, 25 and (3) it is feasible to implement at scale because it is brief and as evidenced by the fact that it is already used widely in US health systems,…”
AI Versus Human-Delivered Online Cognitive Behavioral Therapy for Anxiety Symptoms in Young Adults: A Randomized Controlled Trial
Huang, W., Wu, Y., Shen, Y., Song, H., Chen, Y., Lin, R., Wang, Y., & Yang, X. H. (2026) · Healthcare · doi:10.3390/healthcare14101325 · Cited by 1
“The mean reduction in GAD-7 scores for the peer-counselor group (3.57 points in ITT, 3.96 in PP) approached or met the threshold for a minimally clinically important difference (MCID) of approximately 3–4 points [47].”
Influential
Beyond the Inflammation: Integrating Mental Health Into Rheumatic Disease Care
Lin, Y., Chen, Y., Lee, Y., & Hung, C. (2026) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.70689
Clinical Subtypes of Premenstrual Dysphoric Disorder Among Chinese College Students: A Latent Class Analysis
Sun, Y., Huang, S., Chen, Y. C., Zhang, Q., & Zhang, Y. (2026) · Perspectives In Psychiatric Care · doi:10.1155/ppc/5276137
Clinical profile of headache attributed to anxiety and depressive disorders: an observational study
Chen, B., Zhang, S., Yang, J., Yan, X., Wang, C. C., & Wan, D. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1805261
Changes in bowel-movement frequency, gut microbiota, and emotional issues in postoperative constipation patients
Ye, C., Wang, Y., Liu, Y., Zhu, W., Dai, M., Wang, L., Xu, Y., Li, L., Liu, Z., Ni, L., et al. (2026) · Gastroenterology report · doi:10.1093/gastro/goag024
“By answering each question, a total score ranging from 0 to 21 can be obtained, which is used to determine the severity of anxiety, from none or mild to severe [18].”
Research Progress on the Bidirectional Association between Periodontitis and Anxiety/Depression
林, 哲. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.1651977
Psychological responses to follow-up ultrasound in pregnant women with benign adnexal masses
Qiu, P.-X., & Sun, J. (2026) · Medicine · doi:10.1097/md.0000000000048906
“[19] A total score of >5 was considered indicative of mild anxiety symptoms.”
Digital Interventions to Improve Treatment Adherence in Generalized Anxiety Disorder: A Randomized Clinical TrialPreprint
Gallois, C. B., Machado, M. M., Foppa, G. T., de Oliveira, R. A. L., de Baumont, A. C., Ebert, A. B., Zanelatto, L. A., Rangel, C. C., Lodi, B., dos Santos, L. R., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-9727754/v1
Application of comprehensive cardiac rehabilitation intervention based on King's goal attainment theory in middle-aged and elderly patients after percutaneous coronary intervention
Zhang, B., Dai, Q., Huang, F., & Lv, J. (2026) · International Journal of Clinical and Experimental Medicine · doi:10.62347/lulg5831
Evaluating the Impact of a National Telehealth Outpatient Mental Health Program in Rural Communities
Auerbach, M. M., O'Neill, C., George, K., Summers, E., & O’Callaghan, E. (2026) · Healthcare · doi:10.3390/healthcare14111557
“Measure-specific MCID for PHQ-9 was defined as a >5-point reduction in scores and GAD-7 as >4-point reduction, consistent with prior research examining MCID in anxiety [23].”
Changes in anxiety, quality of life, and functioning following psilocybin-assisted therapy in veterans with treatment-resistant depression
Kelly, C. M., Fradet, M., Bostian, C. M., Donnelly, A. J., Ellis, S., Ostacher, M. J., Aaronson, S., & Suppes, T. M. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122063
Mediating Effect of Oral Behaviors between Emotional Symptoms and Temporomandibular Joint Disorders in Medical Students
李, 晓. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.1662254
Prevalence and Predictors of Anxiety Severity Among Health Sciences Students: A Cross-Sectional Study Using the GAD-7 Scale
Segawa, V. K., Nakano, J. M. T., Blaas, I. K., & Castaldelli-Maia, J. M. (2026) · Medicina Clínica y Social · doi:10.52379/mcs.v10.805
Pre-COVID-19 Sexuality-Based Stigma Predicts Mid-Pandemic Anxiety Increases in a Cohort of Sexual Minority Men in the United States
Wiginton, J. M., Xu, H., Tian, J. L. H., Xue, Q., Baral, S., Sanchez, T. H., & Murray, S. M. (2026) · International Journal of Social Psychiatry · doi:10.1177/00207640261456760
“…we documented, though statistically significant, were below commonly used thresholds indicative of clinical significance (Bischoff et al., 2020; Toussaint et al., 2020), though they do reflect findings from other longitudinal studies tracking anxiety during the early months of the pandemic…”
Imagery rescripting for generalized anxiety disorder: A case series
Stavropoulos, L., Phipps, A. B., Sabel, I., Cooper, D. D. J., Briggs, N., Newby, J. M., & Grisham, J. R. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70073
Efficacy of psychological treatments for perinatal depression and anxiety: systematic review and network meta-analysis
Leng, L. L., Xiao, W., He, X., Wang, T., & Ning, K. (2026) · The British Journal of Psychiatry · doi:10.1192/bjp.2026.10694
Engagement and Outcomes Associated With Message-Based Psychotherapy Among Older and Younger Adults
Renn, B. N., Peake, E. E., Brody, L. A., Padmanabhan, A., & Raue, P. J. (2026) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2026.06.016
UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Autism Spectrum Disorder
Aggarwal, A., Erridge, S., Varadpande, M., Clarke, E., McLachlan, K., Coomber, R., Asghar, M., Bhoskar, U., Crews, M., Angelis, A. D., et al. (2026) · Neuropsychopharmacology Reports · doi:10.1002/npr2.70146
Joint Effects of Early Pandemic Containment Policies on Anxiety in the United StatesPreprint
Watts, D., Khadse, P. N., Ebrahimi, O. V., Tubbs, J. D., Lian, J., Dall’Aglio, L., Fatori, D., Zhou, Y., Zuccolo, P. F., Cudic, M., et al. (2026) · medRxiv · doi:10.64898/2026.06.29.26356856
A Real-World Evaluation of Treating Post-traumatic Stress Disorder in Military Veterans with Eye Movement Desensitization and Reprocessing Therapy: Comparing EMDR-Indoors and EMDR-Outdoors
Graham, J. (2026) · Journal of EMDR Practice and Research · doi:10.34133/jemdr.0039

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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

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

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks