29 Clinical and personal recovery, a meta-analysis Sensitivity analysis Rosenthal Fail-Safe N = 869 suggests that there would need to be more than 800 negative unpublished studies included in the meta-analysis to result in a nonsignificant population effect size. The funnel plot does not suggest publication bias (supplementary material). Clinical recovery and empowerment Seven studies investigated the relationship between symptom severity and empowerment. Five of 7 studies (n = 1793) could be included in the meta-analysis, since in 2 studies it was not possible to calculate an effect size of the relationship between overall psychopathology and empowerment (53, 54). Of the 1793 participants, most were male (68.8%) and outpatients. The mean age was 40.6. All studies reported mainly on patients with longer duration of psychosis. Again, heterogeneity across studies was substantial (I2 = 86.7, 95% CI = 71.2-93.9, Q = 30.1, P > .001). The random-effect meta-analysis revealed a significant mean weighted correlation coefficient of r = -.23 (95% CI -0.36 to -0.09, P < .001). Figure 4 shows the forest plot of individual effect sizes and 95% confidence intervals for the association between overall symptom severity and empowerment. Due to the small number of included studies, no additional sub-sample analyses regarding different symptom domains and functioning, or meta-regression analyses were conducted. Sensitivity analysis Rosenthal Fail-Safe N = 118 suggests that there would need to be more than 100 negative unpublished studies included in the meta-analysis to result in a nonsignificant population effect size. The funnel plot does not suggest publication bias (supplementary material). 2
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