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Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Original Article 

Prevalence of Nosocomephobia –  

Hospital Related Depression 
Zehra Ashraf, Syeda Arooba Raza, Fizza Khalid, Zahra Sabzwari and Dur-re-Shahwar 

Faculty of Pharmacy, Jinnah University for women, Karachi, Pakistan 

Corresponding Author: dr.zehra.ashraf@gmail.com    

 

Abstract 

Aim of research Study: The aim of study was to assess hospital phobia and its variation of depressive symptoms in 

primary care population. Introduction: Nosocomephobia is the fear of hospitals. It is a fairly common phobia; many 

people are known to suffer from it. Like that “If I go to a hospital, I’m fairly sure it is a fact that my life is not  

guaranteed.” Patients are afraid of hospitals, especially the emergency rooms. Hospitals are the mark of cure and 

health. They even usually result in huge expenses. Most people understand that it is a medical necessity and that one 

does not and fear must be overcome in case of Nosocomephobia though, the patient simply refuses to go to a 

hospital and the result often are not desirable including death especially in case of major life threatening conditions. 

Result: In Primary Care population (PCP) severity of Hospital-phobia is very high. Patients show different 

depressive symptoms like nausea, loss of appetite, mood swing etc. The result of survey shows that insomnia is the 

highest number found in depressive patients which is approximately 50% in male patients alone. Female the 

percentage is slightly low i.e. approximately 40%. Discussion and Conclusion: A survey has been conducted at 

Karachi to ascertain how many people are suffering from hospital phobia. Our survey result showed that the hospital 

fear (nosocomephobia) is very common in the biggest city of Pakistan i.e. Karachi.  The best way to overcome the 

nosocomephobia is to change the mindset of the patient through some self-help techniques.  

 

Keywords 

Depression, Hospital, Phobia, Phobic disorders, Patient care population 

 

Introduction 

The research into the problem of phobic disorders is 

very extensive. (Beidel, D.C. and Turner, S.M., 

2007). A fear of hospitals and doctors is commonly 

found in the community but is not bounded. When 

such a fear is become irrational and sufficiently 

severe situation and health should be the just 

concerns may arise (Zigmond, A.S. and Snaith, R.P., 

1983). 

 

There are fears in common people about hospitals. 

First of all, it is commonly understood that whenever 

doctor’s advices patient for hospitalization it means 

the illness is very serious Marks, (I.M. and Gelder, 

M.G., 1966). Although it is not necessary but people 

think like that. The second fear of hospital is the 

expenses occurs this in. Unnecessary tests are 

advised which resulted in heavy financial burden as 

well as a painful process (Singh, T.K., Ahmad, A. 

and Chowdhury, A., 2014). 

 

Nosocomephobia is the fear of hospitals. It is a fairly 

common phobia; many people are known to suffer 

from it. Like that “If I go to a hospital, I’m fairly sure 

It is a fact that my life is not guaranteed.” (Pellosmaa, 

H.B. and Desouky, T.F., 2013) Normally, patient 

found ways of dealing with a surge of emotions are 

associated with hospitals. Most people understand 

that it is a medical necessity and that one does not 

and fear must be overcome in case of 

Nosocomephobia though, the patient simply refuses 

to go to a hospital and the result often are not 

desirable including death especially in case of major 

life threatening conditions. (Peters, L., 2000) 

Symptoms of depression are visible in body, mood 

and thoughts and that affects the way a person eats, 

sleeps, self-concern by over thinking. (Hamilton, 

M.A.X., 1959) Depression is not the same as a 

passing blue mood. Fear is not a sign of personal 

weakness. People with depression cannot merely pull 

themselves together’ and get better. (Liebowitz, 

M.R., 1987) 

Physicians are unable to detect emotional disorder 

because they are not confident enough in procedure 

of detection or patient may think that his complaint 

was not being taken seriously. The information about 

this order can be gathered by a Questionnaire which 

the patient may complete. (Zimmerman, M., 

McDermut, W. and Mattia, J.I., 2000). 

 

The questionnaire should be simple and should not 

include reference to abnormal perception. The 

patient’s own views should be considered as he/she is 

the best judge of his/her state .By this questionnaire, it 

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Zehra Ashraf 28 

  

Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

was considered that the methods usually adopted are 

prolonged and desired administration by a trained 

worker, or if short and designed, recognition is 

necessary for proper diagnostic of the patients then 

another questionnaire will be made which will 

distinguish between anxiety and depression and the 

information collected will be very much helpful and 

reliable for the patient to know about the disorder for 

which he was consulting. (Torgersen, S., 1983) Other 

than this order that is Psychiatric lexicon we have 

seen some various state of stress like Grief, loss of 

self-esteem and so on (Fava, M., Rankin 2000). A 

questionnaire includes all these states would be not 

much useful for physicians, so physicians focus on 

loss on pleasure response which is the obligatory 

state of depressive disorder and this is supposed to be 

that it is due to disturbance of neurotransmitter 

mechanism which can be improved by anti-

depressant medication. These depressive states 

reduce the ability to experience pleasure. (Malasi, 

T.H., Mirza, I.A. and El‐Islam, M.F., 1991) The goal 

of study was to assess hospital phobia and its 

variation of depressive symptoms in primary care 

population. 

 

Methodology 

Domain of study: The study of plat was Paris of Asia 

(Karachi) which is the sizeable and populous city of 

Pakistan. The 7th largest and most populous urban 

agglomeration in the World. Karachi metro has an 

estimated population of over 23.5 million people as 

2013. 

Purpose of study: The survey was conducted among 

200 patients, it has been supervise to perceive about 

hospital phobia. For this purpose, a survey was 

sketch to conduct fresh enumeration from different 

parts of Karachi (Pakistan). It was disseminate 

among various divisions of society. The 

questionnaire was based on MCQ’s asking the people 

to give their fair point of view about 

Nosocomephobia that is hospital phobia. Most of the 

people understand that it is a medical necessity and 

that one does not have a choice but to get over with 

it. The patient simply refuses to go to a hospital 

which results in some very negative. Some of the 

questions asked by us included: 

1. Worrying thoughts go through my mind. 

2. I get sudden feelings of panic 

3. I can sit at ease and feel relaxed. 

4. I feel rest less and have to be on the move. 

5. Do you experience any of these symptoms? 

(Like Diarrhea, Insomnia, Abdominal Cramps, 

Nausea, Less Appetite)  

6. What kind of treatment/tests makes you 

frightened? (Like I/V , I/M, Different tests, 

Many medicines, Drips) 

 

Result 

In Primary Care population (PCP) severity of 

Hospital-phobia is very high. Patients show different 

depressive symptoms like nausea, loss of appetite, 

mood swing etc. The survey shows that on 

nosocomphobia i.e. hospital related phobia provided 

us a consistent result as follows: Table 1 shows the 

depression scale which is further divided into three 

categories that are (1) normal having answer scale in 

range 0-7 (2) borderline depression having answer 

scale in range 8-10 and (3) depression having answer 

scale in range 11-21. Table 2.1 and figure 2.1 

representing the depression’s symptoms regarding the 

aspect of males in which four symptoms are shown 

along with their respective percentages, these 

symptoms include diarrhea experienced by 16.88% 

males, insomnia by 40.25%, abdominal cramps by 

18.16%, nausea by 22.60% and less appetite by 

25.95% males respectively. 

 

Similarly, depression’s symptoms are also seen in 

females, table 2.2 and figure 2.2 represents these 

symptoms along with their respective percentages, 

these symptoms includes diarrhea experienced by 

21.94% females, insomnia by 39.83%, abdominal 

cramps by 23.57%, nausea by 16.26% and less 

appetite by 16.26% females respectively 

Reasons of depression being arise from admitting to 

hospital are also taken under consideration of this 

survey which are the sort of treatments which make 

people little worried, depression experienced by 

males from certain treatments is shown in table 3.1 

and figure 3.1 which includes I/V by 33.76%, I/M by 

24.67%, different tests by 40.25%, many medicines 

by 40.25% and drips by 32.46% respectively. 

Similarly, depression experienced by females with 

respect to treatment are discussed in table 3.2 and 

figure 3.2 respectively which includes I/V by 

30.08%, I/M by 14.63%, different tests by 24.34%, 

many medicines by 20.32% and drips by 35.77% 

respectively. 

 

As the age is essential factor which plays a great role 

in any research or survey, the depression according to 

age is also considered and table 4.1 is and figure 4.1 

are representing the depression scale along with 

respective ages with respect to males, the ranges of 

age under which the percent of depression lies are: 

(a)15-25 in which depression % is about 11.68% (b) 

26-36 in which depression % is about 9.09% (c)37-47 

in which depression % is about 3.89% (d) 48-60 in 

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Zehra Ashraf 29 

  

Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

0-7

8-10

11-21

Answer Scale

Normal

Borderline

Depression

Depression

which depression % is about 3.89% respectively. 

Similarly, the ranges with respect to females are: 

(a)15-25 in which depression % is about 14.28% (b) 

26-36 in which depression % is about 7.79% (c)37-47 

in which depression % is about 5.19% (d) 48-60 in 

which depression % is about 11.6% respectively. 

Table 5.1 and figure 5.1 represents borderline 

depression related to hospital with respect to males 

which comprises of age range along with percentages 

of borderline depression, these are: (a)15-25 in which 

depression % is about 14.28% (b) 26-36 in which 

depression % is about 7.79% (c)37-47 in which 

depression % is about 5.19% (d) 48-60 in which 

depression % is about 11.6% respectively. Similarly, 

table 5.2 and figure 5.2 represents borderline 

depression related to hospital with respect to females 

which comprises of age range along with percentages 

of borderline depression, these are: (a)15-25 in which 

depression % is about 17.88% (b) 26-36 in which 

depression % is about 8.94% (c)37-47 in which 

depression % is about 4.87% (d) 48-60 in which 

depression % is about 2.43% respectively.  

 

Normal people without any sort of depression are 

also taken under consideration, the table 6.1 and 

figure 6.1 showing the % of normal males according 

to age range which are as follows: (a)15-25 in which 

normal % is about 18.18% (b) 26-36 in which normal 

% is about 7.79% (c)37-47 in which normal % is 

about 3.89% (d) 48-60 in which normal % is about 

3.89% respectively. Similarly, the table 6.2 and 

figure 6.2 showing the % of normal females 

according to age range which are as follows: (a)15-25 

in which normal % is about 32.52% (b) 26-36 in 

which normal % is about 4.87% (c)37-47 in which 

normal % is about 4.06% (d) 48-60 in which normal 

% is about 1.62% respectively.

 

 

 

Figure # 2.1: Hospital Depression’s Symptoms appears in Male 

 

 
Figure # 2.1: Hospital Depression’s Symptoms appear in Male 

 

 
Figure # 2.2: Hospital Depression’s Symptoms appear in Female 

16.88%

40.25%

18.16% 22.60% 25.95%

Diarrhea Insomnia Abdominal Cramps Nausea Less Apetite

Symptoms

21.94%

39.83%

23.57%
16.26% 16.26%

Diarrhea Insomnia Abdominal Cramps Nausea Less Apetite

Symptoms

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Zehra Ashraf 30 

  

Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 
Figure # 3.1: Reasons of Depression from Admitted to Hospital (Male) 

 

 
Figure # 3.2: Reasons of Depression from Admitted to Hospital (Female) 

 
Figure # 4.1: Hospital Depression in Male 

 
Figure # 4.2: Hospital Depression in Female 

33.76% 24.67%
40.25% 40.25%

32.46%

I/V I/M Different Tests Many Medicines Drips

Treatments

30.08%

14.63%
24.34% 20.32%

35.77%

I/V I/M Different Tests Many Medicines Drips

Treatments

11.68%
9.09%

3.89%

3.89%

Depression

15-25
26-36
37-47
48-60

8.94%

3.25%

6.50%

3.25%

Depression

15-25

26-36

37-47

48-60

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Zehra Ashraf 31 

  

Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 
Figure # 5.1: Hospital’s Borderline Depression in Male 

 
Figure # 5.2: Hospital’s Borderline Depression in Female 

 
Figure # 6.1: Normal Male among Survey People 

 
Figure # 6.2: Normal Female among Survey People 

14.28%

7.76%

5.19%

11.60%

Borderline depression

15-25

26-36

37-47

48-60

17.88%

8.94%

4.87%

2.43%

Borderline depression

15-25

26-36

37-47

48-60

18.18%

7.79%

3.89%

3.89%

Normal male

15-25

26-36

37-47

48-60

32.52%

4.87% 4.06% 1.62%

15-25 26-36 37-47 48-60

Age range

Normal female

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Zehra Ashraf 32 

  

Annals of Psychophysiology                                                                                                        Volume 3, October 2016                  
©Advance Educational Institute & Research Centre                                                                    www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Discussion & conclusion 

A survey has been conducted at Karachi to ascertain 

how many people are suffering from hospital phobia. 

Our survey result showed that the hospital fear 

(nosocomephobia) is very common in the biggest city 

of Pakistan i.e. Karachi. Many people are frightened 

to enter the hospital buildings, some of them are 

scared of blood, germs, surgical procedures, some 

patients feel nervousness about the procedures 

because they can cause pain in the body. (Starcevic, 

V. and Bogojevic, G., 1997) Nosocomephobia causes 

different depressive symptoms like heart palpitations, 

dizziness, insomnia, diarrhea etc. (Robertson, J.G., 

2003). Result of survey shows that insomnia is the 

highest number found in depressive patients which is 

40.2% in male whereas in female it is slightly low i.e. 

39.8% The best way to overcome the 

nosocomephobia is to change the mindset of the 

patient through some self-help techniques. If you are 

in phobia never go to hospital alone take some 

friends with you. In hospital’s waiting area read your 

favorite books or talk with your friends otherwise go 

to hospital café and enjoy tea/coffee to relax your 

mind (Brinton, H.G., 2012).  

 

Some treatments are also available for 

nosocomephobia, it is treated with the combination of 

medicine (Robertson, J.G., 2003). Prescriber 

prescribes anti-anxiety a medication which helps to 

decrease the depressive disorders but it is not 

recommended for long time treatment/use. Some 

psychotherapy, talk therapy are also recommended. 

For the facilitations of patients minimize the 

unnecessary pathological tests which irritate patients 

which also increase the hospital charges. 

 

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