**6. Conclusion**

Sport is a universal language, recognized and shared by all. It promotes well-being, self-esteem and social relationships, it improves compliance and fosters an active attitude of the users/ athletes; no one feels excluded.

We think that sport is a very useful and inexpensive tool in the overall frame of the treatment of schizophrenic disorders. During the first definition of the therapeutic program, sport promotes the establishment of a good relationship with the treating team and improves the adherence to treatment. It introduces the new users, especially young people, in a friendly and fun environment that helps them to overcome many misconceptions about the role of a "psychiatric patient," by seeing other people, who are users and athletes, well integrated into society. Moreover, it is an appropriate form of secondary prevention against chronic medical conditions related to sedentariness, avoiding weight gain and its deleterious effects on health, quality of life, general functioning and compliance.

In a subsequent period, it becomes targeted to specific needs of individual cases and assumes a greater significance as an effective tool for psychiatric rehabilitation, easy to implement and inexpensive. It can reduce the hospitalizations, improve Social Functioning, achieve a good quality of life, promote social inclusion and functional recovery. Schizophrenia is not a malignant disease that inevitably deteriorates over time [43]: we must work to promote recovery in every single person.

Sport allows gradually regaining a role in a social environment and finding a life domain where the disease remains outside. In our opinion, team sports have a high therapeutic value. The team is not a sum of individuals, but a unique "entity." In an ideal society, the individuals fade away and the players become a "single body" whose parts interact each other. The stronger parts support the weaker parts; the resources of all are at stake and enhanced to create that Universe-Group which aims to get the best result. Play on a team means to know and apply the rules of the sport, find the correct position on the field, learn and use specific technical skills, collaborate with others, respect fellow and opponents. The victory is a moment of cohesion and sharing of positive emotion: the result of everyone's work; even the defeat, though, is constructive, producing reflection and the reorganization of the work of the team. It is not a rewarding experience, but it's definitely a growth factor and analysis: sport teaches us to accept failures as part of a learning process or as one of the factors of the game.

Fitness, technical skills, attention, observation skills, and willingness to cooperate: these are all important factors and build expertise and resources that, if exploited, give a role in the team and increase self-esteem. Within the teams, valid relationships can grow and continue beyond the classes, producing autonomous leisure opportunities.

In our opinion, sport "treatment" combines the features of the clinical work, of clinical research and of self-help systems. We think that the treatment of schizophrenia requires a personalized approach, which evaluates the characteristics and needs of each individual: this also applies to exercise and sport: we always prefer the concept of "sport" to that of "exercise," for its value on self-esteem and social integration. In our experience of users, we suggest starting out, especially in the post-acute phase, with the proposal to an individual activity such as gymnastics, allowing a period of observation and adaptation to the movement in a friendly but not too-demanding environment. Subsequently, we propose to try an additional sport, according to the therapeutic needs and preferences of the individual subject; after an initial phase of welcome, the user will continue to practice weekly, at least for a year. Many users continue to practice sports for years, when they are symptoms-free and also after finishing their course of treatment, as volunteers.

Our and others experiences using sport in the treatment of schizophrenia may act as suggestion and encouragement toward a research centered on outpatients, using shared outcome indicators and providing for a sufficiently long follow-up, to evaluate the persistency of benefits over time. It would be very interesting also to carry out research on the different sports and on their various potentially therapeutic factors.
