INTRODUCTION The purpose of this study was to investigate the relationships among self-focused attention, mindfulness and distress caused by the voices in psychiatric patients. METHODS Fifty-one individuals with a psychiatric diagnosis participated in this study. The Psychotic Symptom Rating Scale (PSYRATS) emotional factor was applied to measure the distress caused by the voices, the Self-Absorption Scale (SAS) was given for measuring the levels of self-focused attention, and the Mindful Attention Awareness Scale (MAAS) was used to measure mindfulness. RESULTS The results showed that distress caused by the voices correlated positively with self-focused attention (private and public) and negatively with mindfulness. A negative correlation was also found between mindfulness and self-focused attention (private and public). Finally, multiple linear regression analysis showed that public self-focus was the only factor predicting distress caused by the voices. CONCLUSIONS Intervention directed at diminishing public self-focused attention and increasing mindfulness could improve distress caused by the voices.