{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:55:58Z","timestamp":1786636558411,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Understanding the meanings people attribute to observed events and lived experiences is to unveil their symbolic universe, thus allowing us to help them better manage their emotions, reactions, and relationships, particularly in clinical settings. Patients with schizophrenia resistant to treatment with first\u2010 and second\u2010generation antipsychotics respond well to clozapine; however, this medication presents agranulocytosis as an important side effect. Consequently, the medication protocol requires frequent blood draws to monitor any effects on blood cells. Investigating patients\u2019 perceived emotional experiences of this procedure triggered our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To interpret emotional and\/or symbolic meanings attributed by patients with schizophrenia to the clozapine treatment protocol during follow\u2010up at a university outpatient service specializing in psychiatry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A clinical\u2010qualitative study was conducted based on Turato's design. Data were collected by means of in\u2010depth semi\u2010directed interviews with open\u2010ended questions conducted in\u2010person with participants using clozapine. Sampling followed Fontanella's theoretical information saturation criterion. Data were explored by Faria\u2010Schutzer's clinical\u2010qualitative content analysis (CQCA), employing psychodynamic concepts from Medical Psychology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analysis of nine interviews resulted in four categories: (1) the frequent blood collections foreseen by the protocol seem to have little impact on patient's symbolization and treatment adherence; (2) \u201cI come here to stay alive\u201d: the frequent blood collections foreseen by the protocol seem to have a good impact on patient's treatment adherence; (3) Reframing a psychiatric illness: the protocol reinforces the embodiment of a medical diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Faced with a socially and psychologically non\u2010silent mental disorder, management of schizophrenic symptoms seems to suppress patient symbolization of the blood count collection protocol and the risk of agranulocytosis. Moreover, the protocol appears to promote safety and favor treatment adherence, as well as to provide a greater level of social integration by inserting patients into the health system dynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the repetitive experience of blood collection for rigorous effect control, such a ritual does not seem to bring about symbolizations \u201cmore charged\u201d than the chronicity of the disease itself. Therefore, patients benefit from the frequent blood collections, as it secures them from possible social isolation by promoting social interaction. These benefits can help patients to develop new meanings for their life condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71034","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T06:34:18Z","timestamp":1763793258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived Experience of the clozapine Treatment Protocol: A Qualitative Study of Reports by Brazilian Patients With Schizophrenia Treated in a University Outpatient Service Specializing in Psychiatry"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-5152","authenticated-orcid":false,"given":"Jo\u00e3o Batista","family":"Alves dos Santos","sequence":"first","affiliation":[{"name":"Laboratory of Clinical\u2010Qualitative Research, Department of Psychiatry, School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4220-2642","authenticated-orcid":false,"suffix":"J\u00fanior","given":"Francisco Carlos","family":"Specian J\u00fanior","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical\u2010Qualitative Research, Department of Psychiatry, School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-7236","authenticated-orcid":false,"given":"Lucas Serra","family":"Vallad\u00e3o","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical\u2010Qualitative Research, Department of Psychiatry, School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9870-6391","authenticated-orcid":false,"given":"Paulo","family":"Dalgalarrondo","sequence":"additional","affiliation":[{"name":"Professors At the Department of Psychiatry School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-2585","authenticated-orcid":false,"given":"Clarissa Rosalmeida","family":"Dantas","sequence":"additional","affiliation":[{"name":"Professors At the Department of Psychiatry School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7857-1482","authenticated-orcid":false,"given":"Egberto","family":"Ribeiro Turato","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical\u2010Qualitative Research, Department of Psychiatry, School of Medical Sciences Universidade Estadual De Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100447.2011.01776.x"},{"key":"e_1_2_15_3_1","volume-title":"In: StatPearls [Internet]","author":"Haidary H. 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R..Tratado Da Metodologia Cl\u00ednico\u2010Qualitativa: Constru\u00e7\u00e3o Te\u00f3rico\u2010Epistemol\u00f3gica Discuss\u00e3o Comparada Nas \u00c1reas Da Sa\u00fade e Humanas [Treatise on Clinical\u2010Qualitative Research Methodology: Theoretical\u2010Epistemological Construction Comparative Discussion and Application in the Health and Humanities Areas]. 6 ed. 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