Abstract: Objective: To explore the relationship between family caregiver burden in schizophrenia and patients' stigma, and to analyze the chain mediating roles of caregivers' trait mindfulness and perceived social support in this relationship.Methods: A cross-sectional survey was conducted using a convenience sampling method among 357 pairs of patients with schizophrenia and their primary family caregivers in Changning and Huangpu Districts of Shanghai from August to December 2023. Relevant variables were assessed using the Stigma Scale for Chronic Illness 8-item version (SSCI-8), the Caregiver Burden Inventory (CBI), the Mindful Attention Awareness Scale (MAAS), and the Multidimensional Scale of Perceived Social Support (MSPSS). Pearson correlation analysis, hierarchical regression analysis, and Bootstrap method were employed to test the chain mediating effect.Results: Patient stigma was significantly positively correlated with caregiver burden (r = 0.516, P < 0.001), and significantly negatively correlated with both trait mindfulness (r = -0.412, P < 0.001) and perceived social support (r = -0.317, P < 0.001). Mediating effect analysis revealed that trait mindfulness, perceived social support, and their combined chain pathway all exerted significant mediating effects between patient stigma and caregiver burden, with the total mediating effect accounting for 44.6% of the total effect.Conclusions: Patient stigma in schizophrenia was significantly positively associated with family caregiver burden, and caregivers’ trait mindfulness and perceived social support played significant chain mediating roles in this relationship. These findings suggest that mindfulness-based interventions and the enhancement of family and community social support may help mitigate the negative impact of patient stigma on caregiver burden, thereby improving caregivers’ psychological well-being.