The Role of Mentalizing and Alexithymia in Burnout Among Physicians

Background Burnout among physicians is a major global public health problem with significant implications for both healthcare professionals and patient care. This study aimed to examine the associations between sociodemographic characteristics, alexithymia, mentalizing capacity, and different dimensions of burnout among physicians in Montenegro, as well as to assess their independent contributions. Methods A cross-sectional study was conducted among 235 physicians employed in primary, secondary, and tertiary healthcare settings. Burnout was assessed using the Maslach Burnout Inventory, alexithymia using the Toronto Alexithymia Scale (TAS-20), and mentalizing capacity using the Reflective Functioning Questionnaire (RFQ-8). Nonparametric analyses, correlation analyses, and hierarchical linear regression were applied. Results The regression model showed that emotional exhaustion was positively associated with hypomentalization (β = 0.17, p < 0.05), while hypermentalization (β = -0.47, p < 0.001) and alexithymia (β = -0.20, p < 0.01) were negatively associated, with the model explaining 40.0% of the variance (R² = 0.400). For depersonalization, hypomentalization (β = 0.19, p < 0.05) and hypermentalization (β = -0.26, p < 0.001) were significant predictors, with the model explaining 20.6% of the variance (R² = 0.206). Alexithymia was not statistically significant. No psychological variable was significantly associated with personal accomplishment. Conclusion Mentalizing capacity appears to be an important factor associated with burnout among physicians, while the role of alexithymia appears limited and context-dependent. These findings may have implications for the development of interventions aimed at supporting physicians’ mental health in high-stress healthcare environments.