We may hypothesize that anxiety could determine a secondary demoralization in BMS patients (depression) and depressive symptoms could contribute to pain, accordingly. Therefore, pain could be a somatic feature of depression. Our findings provide an example of a possible pathogenetic model for BMS.

Our study suggests that specific attention should be given to patients' family context, due to its crucial role in daily informal care and in the triggering of events leading to rehospitalization.

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