Background: Psychological distress, including anxiety, stress, and depression, is common and expected in women with newly diagnosed metastatic breast (MBC) or lung (MLC) cancer. This study examined short-term changes in depression, anxiety, and stress and the associations of such changes with demographic, lifestyle, and religiosity factors. Methods: This prospective longitudinal study included 121 women (66 with MBC and 55 with MLC) who attended two oncology clinics in Montenegro between July 2024 and February 2025. Psychological symptoms were assessed at baseline (T1) and three months after treatment initiation (T2) using the Depression Anxiety Stress Scale-21 (DASS-21) and the Anxiety Sensitivity Index (ASI). Due to the non-normal distribution of residuals, multivariable quantile regression models (median regression, tau = 0.5) were used to examine independent predictors of psychological outcomes at T2, adjusting for baseline symptom severity, demographics, and clinical factors. Results: Baseline DASS-21 and ASI scores were comparable between the MBC and MLC patients. At three-month follow-up, depressive symptoms decreased in the overall cohort, driven by improvement among patients with MLC. Patients with MBC showed increased anxiety and stress over time, whereas patients with MLC showed reductions in depression and stress. At follow-up, anxiety was significantly higher in the MBC group than in the MLC group. The perceived importance of faith showed weak negative correlations with distress (ρ ranging from −0.227 to −0.242; all p = 0.01), while younger age was strongly associated with higher baseline distress in the MLC group (ρ = −0.431 to −0.688; all p < 0.001). In the multivariable median regression models, baseline symptom severity was the strongest predictor of psychological outcomes at T2 (p < 0.001). Additionally, cancer type was a significant independent predictor of depression at follow-up (B = −1.258; p < 0.001), with MLC associated with lower scores compared to MBC. Conclusions: Psychological distress is a common phenomenon during the first months after the diagnosis of metastatic cancer. Our results support the importance of early psychological assessment and tailored support in routine oncology practice.
Saveljić et al. (2026) studied this question.