Predictors of stigmatizing attitudes toward mental illness among non-psychiatric physicians: a cross-sectional study at Tanta University Hospitals

Background Stigmatising attitudes toward mental illness among non-psychiatric physicians may create barriers to equitable mental health care. Occupational burnout may be associated with these attitudes; however, this relationship remains insufficiently investigated in general hospital settings. Objective To assess stigmatising attitudes toward mental illness among non-psychiatric physicians and examine their associations with specialty, burnout dimensions, psychiatric history, and previous psychiatric training. Methods This analytical cross-sectional study included 300 non-psychiatric physicians. Data were collected over three months, from July to September 2026. Stigma was measured using the 16-item MICA-4, and burnout was assessed using the 22-item Maslach Burnout Inventory–Human Services Survey (MBI-HSS), both administered in English. Analyses included descriptive statistics, independent-samples t tests, one-way ANOVA with Bonferroni-adjusted comparisons, Pearson correlations, multiple linear regression, and an exploratory interaction model. Results The mean MICA-4 score was 43.11 ± 9.31 (range, 19–70). MICA-4 scores differed by specialty, F(2, 297) = 6.53, p = .002, η² = 0.042. Acute-care physicians scored higher than medical physicians after Bonferroni correction ( p = .002); differences between medical and surgical physicians ( p = .054) and between surgical and acute-care physicians ( p = .831) were not statistically significant. In multivariable analysis, surgical specialty (B = 2.79, p = .010), acute-care specialty (B = 5.32, p < .001), emotional exhaustion (B = 0.26, p < .001), and depersonalisation (B = 0.48, p < .001) were positively associated with MICA-4 scores, whereas previous psychiatric training (B = − 4.39, p < .001), personal psychiatric history (B = − 3.13, p = .016), family psychiatric history (B = − 3.25, p = .007), and personal accomplishment (B = − 0.21, p = .002) were inversely associated. The model explained 41.4% of the variance (adjusted R² = 0.393). The exploratory depersonalisation × training interaction was significant (B = − 0.41, 95% CI − 0.79 to − 0.04, p = .030, ΔR² = 0.009). The depersonalisation slope was significant among physicians without prior psychiatric training (B = 0.61, 95% CI 0.38–0.83, p < .001), but not among those with prior training (B = 0.19, 95% CI − 0.13–0.52, p = .245). Conclusion Stigmatising attitudes were associated with burnout dimensions, specialty, psychiatric history, and previous psychiatric training. The exploratory interaction suggests that the association between depersonalisation and MICA-4 scores differed by previous psychiatric training; however, the cross-sectional findings do not establish causality or a protective effect of training.