Universität zu Köln

Fusar-Poli, Paolo ORCID: 0000-0003-3582-6788, Schultze-Lutter, Frauke, Cappucciati, Marco, Rutigliano, Grazia ORCID: 0000-0001-6014-5357, Bonoldi, Ilaria, Stahl, Daniel ORCID: 0000-0001-7987-6619, Borgwardt, Stephan, Riecher-Rossler, Anita ORCID: 0000-0001-6361-8789, Addington, Jean, Perkins, Diana O., Woods, Scott W., McGlashan, Thomas, Lee, Jimmy ORCID: 0000-0002-7724-7445, Klosterkoetter, Joachim, Yung, Alison R. and McGuire, Philip ORCID: 0000-0003-4381-0532 (2016). The Dark Side of the Moon: Meta-analytical Impact of Recruitment Strategies on Risk Enrichment in the Clinical High Risk State for Psychosis. Schizophr. Bull., 42 (3). S. 732 - 744. OXFORD: OXFORD UNIV PRESS. ISSN 1745-1701

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Abstract

Background: The individual risk of developing psychosis after being tested for clinical high-risk (CHR) criteria (post-test risk of psychosis) depends on the underlying risk of the disease of the population from which the person is selected (pretest risk of psychosis), and thus on recruitment strategies. Yet, the impact of recruitment strategies on pretest risk of psychosis is unknown. Methods: Meta-analysis of the pretest risk of psychosis in help-seeking patients selected to undergo CHR assessment: total transitions to psychosis over the pool of patients assessed for potential risk and deemed at risk (CHR+) or not at risk (CHR-). Recruitment strategies (number of outreach activities per study, main target of outreach campaign, and proportion of self-referrals) were the moderators examined in meta-regressions. Results: 11 independent studies met the inclusion criteria, for a total of 2519 (CHR+: n = 1359; CHR-: n = 1160) help-seeking patients undergoing CHR assessment (mean follow-up: 38 months). The overall meta-analytical pretest risk for psychosis in help-seeking patients was 15%, with high heterogeneity (95% CI: 9%-24%, I-2 = 96, P <.001). Recruitment strategies were heterogeneous and opportunistic. Heterogeneity was largely explained by intensive (n = 11, beta = -. 166, Q = 9.441, P =.002) outreach campaigns primarily targeting the general public (n = 11, beta = -1.15, Q = 21.35, P <.001) along with higher proportions of self-referrals (n = 10, beta = -. 029, Q = 4.262, P =.039), which diluted pretest risk for psychosis in patients undergoing CHR assessment. Conclusions: There is meta-analytical evidence for overall risk enrichment (pretest risk for psychosis at 38monhts = 15%) in help-seeking samples selected for CHR assessment as compared to the general population (pretest risk of psychosis at 38monhts=0.1%). Intensive outreach campaigns predominantly targeting the general population and a higher proportion of self-referrals diluted the pretest risk for psychosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fusar-Poli, Paolo UNSPECIFIED orcid.org/0000-0003-3582-6788 UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Cappucciati, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Rutigliano, Grazia UNSPECIFIED orcid.org/0000-0001-6014-5357 UNSPECIFIED Bonoldi, Ilaria UNSPECIFIED UNSPECIFIED UNSPECIFIED Stahl, Daniel UNSPECIFIED orcid.org/0000-0001-7987-6619 UNSPECIFIED Borgwardt, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Riecher-Rossler, Anita UNSPECIFIED orcid.org/0000-0001-6361-8789 UNSPECIFIED Addington, Jean UNSPECIFIED UNSPECIFIED UNSPECIFIED Perkins, Diana O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Woods, Scott W. UNSPECIFIED UNSPECIFIED UNSPECIFIED McGlashan, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Jimmy UNSPECIFIED orcid.org/0000-0002-7724-7445 UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Yung, Alison R. UNSPECIFIED UNSPECIFIED UNSPECIFIED McGuire, Philip UNSPECIFIED orcid.org/0000-0003-4381-0532 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-278075
DOI:	10.1093/schbul/sbv162
Journal or Publication Title:	Schizophr. Bull.
Volume:	42
Number:	3
Page Range:	S. 732 - 744
Date:	2016
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1745-1701
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRA-HIGH-RISK; AT-RISK; LONGITUDINAL YOUTH; GENERAL-POPULATION; RECOGNITION; INDIVIDUALS; PREVALENCE; SYMPTOMS; CRITERIA; PEOPLE Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27807