22 Chapter 2 published experiential accounts of recovery by people with schizophrenia, have identified four key processes of personal recovery: finding hope; re-establishment of identity; finding meaning in life; and taking responsibility for recovery (12). Leamy et al. have identified similar categories of personal recovery processes, namely: connectedness, hope, identity, meaning, and empowerment (also known by the acronym “CHIME”) (13). In a more recent study, this framework has been validated as a defensible theoretical base for clinical and research purposes (14). Law and Morrison have found comparable elements in their Delphi study among individuals experiencing symptoms of psychosis (15). Several instruments have been developed, based on the experience of patients, to assess personal recovery (16-19), hope (20) and empowerment (21). In the treatment of patients with schizophrenia, the primary goal traditionally is clinical recovery. So far, inconsistent findings regarding the association between clinical and personal recovery have been published, from large (22) to very small correlations (23), usually negative, but also positive correlations (24). Insight into this association is important, because if clinical and personal domains do not overlap, this may inform mental health services to consider extending their treatment strategies beyond clinical goals to promote personal recovery. Moreover, it would support the implementation of instruments to measure personal recovery in outcome monitoring (25). In this meta-analysis, we aim to investigate the strength of the relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders. Because connectedness, hope, and empowerment have most consistently been identified as relevant categories of personal recovery, we will also assess the relationship between these concepts and clinical measures (13). METHODS Literature search A comprehensive online OvidSP database search was performed, including Embase, MEDLINE, PsycINFO, EBM Reviews, and the Ovid Nursing database from the inception of the individual databases to February 2017, without limits concerning publication status or language domain. The following search terms were used: (“schizophrenia” OR “psychosis” OR “psychotic disorder”) AND ((“recovery” AND (“personal” OR “subjective”)) OR (“connectedness” OR “hope” OR “empowerment”)). In addition, the reference lists of articles that met inclusion criteria were used for further study identification. The title and abstract of each article were manually screened according to the following criteria: (1) the article possibly investigates the relationship between clinical and
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