Background: Public beliefs concerning the causes of mental disorders are important in their effective treatment. The relative importance of public beliefs related to the etiology of mental disorders among Chinese populations and their relationship to other attitudes to mental disorders are poorly understood.

Aims: To investigate the endorsement of beliefs related to the etiology of mental disorders in Macau, in particular, traditional Chinese beliefs, and to explore their relationship to general attitudes towards mental disorders.

Methods: A survey of 361 members of the public measured attitudes towards 32 possible causes of mental disorders as well as contact with and social distance from individuals with a mental disorder.

Results: The results indicated that traditional Chinese beliefs were ranked with relatively low importance compared with psychosocial causes. Traditional beliefs related to two underlying factors and were significantly higher in participants with lower education levels. There was a significant negative correlation between endorsement of traditional beliefs and contact with individuals with a mental disorder and a significant positive correlation between endorsement of traditional beliefs and desired social distance from individuals with a mental disorder.

Conclusion: Factors underlying traditional Chinese beliefs concerning the causes of mental disorders are associated with more negative attitudes towards individuals with a mental disorder, with such beliefs more strongly endorsed by those with relatively lower education levels.