Background: The individual threat of developing psychosis after being tested for clinical high-risk (CHR) criteria (posttest 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. CI: 9%C24%, < .001). Recruitment strategies were heterogeneous and opportunistic. Heterogeneity was mainly explained by rigorous (= 11, = ?.166, = 9.441, = .002) outreach campaigns primarily targeting the general public (= 11, = ?1.15, = 21.35, < .001) along with higher proportions of self-referrals (= 10, = ?.029, = 4.262, = .039), which diluted pretest risk for psychosis in individuals 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 human 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. = 1359; CHR?: = 1160) help-seeking individuals selected for CHR assessment. For excluded studies see supplementary table 3. Four studies employed the Comprehensive Assessment of At-Risk Mental Claims (CAARMS), 3 the Structured Interview for Prodromal/Psychosis-Risk Symptoms (SIPS), 1 the Basel Screening Instrument for Psychosis (BSIP), 1 the Bonn Level for the Assessment of Fundamental Symptoms (BSAPS), and 2 both the SIPS and Schizophrenia Proneness Instrument, Adult version (SPI-A). The mean follow-up time was 37.72 months (SD 27.81, median = 33) (supplementary table 2). The type of the outreach LYRIKS activities and their main targets, as employed by the 11 included studies are qualitatively summarized in number 3, and table 2, respectively. Overall, outreach campaigns primarily targeted mental health professionals and organizations, predominately by means of workshops with counsellors and mental health professionals, outpatients and 3371-27-5 satellite clinics and print press. Although general public-targeting activities and the use of social media were rare, most solutions would operate a site. The proportion of self-referrals across studies was normally only 22.07% (median = 21%, 95% CI: 7.65%C36.49%). Pretest Risk of Psychosis in Help-Seeking Individuals Selected for CHR Assessment There was high heterogeneity across studies (< .001), with high variability of pretest 3371-27-5 risk of psychosis at the average 38-month follow-up, ranging from 3%29 to 49%.32 The overall meta-analytical estimate of pretest psychosis risk in Cxcr4 help-seeking individuals selected for CHR assessment (both CHR+ and CHR?), mainly of high-risk services, is definitely 15% (95% CI: 9%C24%) (number 4). Level of sensitivity analyses confirmed robustness of the results. The funnel storyline did not reveal significant publication biases (test for publication biases, > .05). Fig. 4. Meta-analytical estimate of pretest risk of developing psychosis (at an average follow-up of 38 weeks) in 2519 help-seekers at high-risk solutions reported in the 11 studies included. There was large and significant between-studies heterogeneity. Effect of Type of Recruitment Strategies on Pretest Riks of Psychosis There was 3371-27-5 a significant effect of type of recruitment strategies within the pretest psychosis risk of samples selected 3371-27-5 to undergo CHR assessment. Studies primarily directing their 3371-27-5 outreach campaigns to mental health solutions and with few self-referrals experienced increased pretest risk of psychosis compared to studies primarily reaching out to the general public and with a high proportion of self-referrals, with studies adopting a mixed outreach approach lying in an intermediate position (= 11, = ?1.15, intercept = 0.491, = ?4.620, = 21.35, < .001, 95% CI: from ?1.632 to ?0.659, = 11, = ?.166, intercept = ?0.788, = ?3.073, =.