What Is Tetraphobia?

  • Olajide Otuyemi BPharm, Olabisi Onabanjo University, Nigeria; MPH University of Ilorin, Nigeria; MSc. Drug discovery, development, and delivery, Liverpool John Moores University, UK


Tetraphobia refers to the inherent fear of the number four. It is prevalent in many Chinese cultures, and it stems from the speech sounds of the word four in the native language, which is pronounced in a very similar way to the word for ‘death’. Hence, the number four is associated with evil or death. 


Phobia is considered a type of mental illness or anxiety disorder that causes an individual to be so worried about a situation or things, so much so that it affects their day-to-day functioning and perceptions of their realities. An individual who suffers from a phobia has a severe fear of an object, activity, or situation, which leads them to compulsively avoid these. ‘Phobos’ is the origin word from which phobia was obtained. It is a Greek word for fear or panic. A phobia is generally caused by a previous negative experience that has caused the individual to build an inherent fear in their subconscious mind. Generally, the phobia is subdivided into specific, social, and agoraphobia. Some specific phobias may include the fear of certain situations, injury, or some natural environments or animals. Social phobia is when an individual is afraid of certain situations and is worried other people will judge them for one reason or the other. Agoraphobia, however, is the fear of leaving a ‘safe space’ or being out of a familiar area.1

Tetraphobia is from the Greek word ‘tetra’, which means ‘four’- whereby there is a persistent fear of the number four. Tetraphobia originates in Chinese cultures where the pronunciation of the number four sounds similar to the word for ‘death’, and this occurs in some other cultures with Sino-Xenic vocabulary. The root of the dread of this word comes from linguistics. Consequently, in many Cantonese cultures in China, it is typical to find high-rise buildings without floors with the number 4 in them. Rather, these may be replaced as 3A, 13A, 23A, and so on.2 

Cultural significance

Numerology is a significant aspect of Chinese culture. Meanings are attributed to numbers, their pronunciation and positioning. Popular beliefs in these societies associate certain numbers with luck, the probability of being something, and strengths and weaknesses, to name a few. According to a 2015 study on Chinese numerology by Yau Hau Tse* Andrew, numbers 1,3,5,7,9,11 are identified as Yang (= male) numbers, while the even numbers 2,4,6,8,10,12 are identified as Yin (= female). How a number sounds has also been found to be important. When a number sounds identical to another word that has positive meanings, it is considered a positive number and vice versa. For example, ‘8’ is considered a favourable number because it sounds like the Cantonese word for ‘Prosperous’. The number ‘4’, on the other hand, phonologically sounds like death and is therefore associated with negativity, thereby creating fearful interpretations and associations in the minds of many people.3

This phenomenon is why Taiwanese and South Korean natives do not use the number ‘4’ when numbering their ships. Similarly, since 2008, Samsung has encountered some tetraphobia in its new 5-character model numbering of its products. The numbering of models with numbers including ‘4’ has been ended. This is also similar to the Nokia mobile phone series’ numbering systems; any number that starts with 4 is no longer used to avoid negative interpretations from Asian cultures. However, it is intriguing to note that the Chinese government still possesses military designations with the number 4 in its system. An example is ‘Type 094 Nuclear Submarine’. Similarly, studies show that there are no significant effects on the behaviour of the Asian stock market.2 

Tetraphobia exists in some East and Southeast-Asian countries such as China, Taiwan, Malaysia, South Korea, Japan, Singapore, and Vietnam. The fear of the number four even influences charity in these regions; attention is paid to the amount of charity done so as not to have the number 4. Even vending machines skip the number four.4 

Philips et al. conducted a study to investigate the psychological effects associated with the number 4. According to the authors, the word four in Mandarin, Cantonese, and Japanese sounds just like the word for ‘death’. It was claimed that in America, individuals of Chinese and Japanese heritage exhibited more fatal cardiac deaths, such as heart attacks on the 4th day of the month. This phenomenon was termed the ‘The Baskervilles effect’, which is based on the tale by Sir Arthur Conan Doyle in which Sir Charles Baskerville dies due to a heart attack triggered by psychological stress. The authors opine that the word for death sounds similar to the word for death in Cantonese, and the number four is therefore viewed as a connotation for bad luck. In Mandarin, however, there may not be an association between the words. To the Japanese, four may be considered as both favourable and unfavourable. In Cantonese, the numbers 14 and 24 are even associated with the worst connotations because they sound like ‘must die’ and ‘easy to die’ respectively. These words, therefore, trigger a lot of discomfort among Cantonese people. Findings from subsequent studies disproved the claim about heart attacks in the United States on specific ‘unlucky dates’, and investigations of suicide rates on these dates further showed no associations between the date numbers and their occurrences.5,6 Therefore, ‘The Baskervilles effect’ has no scientific basis, and no associations were found between ‘unlucky dates’ and cardiac mortalities among individuals of Chinese heritage.

Superstitious beliefs are unscientific. The evolution of humans has made us more prone to causal thinking than lower animals, and this stems from humans' attempts to analyse the world in which we live. Alteration of a particular expected order of things helps us form beliefs, even if it is a wrong association between a cause and effect. It is planted in human fears and insecurities from irregular and unintelligible natural forces, and it tries to interact with its surroundings as a concept that is well understood and can be controlled and predicted. However, it is noteworthy that superstitions are not based on scientific findings. Examples of superstitions in other cultures include astronomy, magic, and the belief that the number 13 signifies ‘ill luck’ among many others. Studies show that belief in superstition is deeply rooted in human evolutionary and psychological development right from childhood. It is, therefore, not abnormal behaviour and not limited by cultural background, racial class, religion, or educational level. Rather, we all have some kind of superstitious beliefs ingrained into our neuronal framework, but they just vary from one society to the other.7 

Diagnosis and management

As with most phobias, the signs and symptoms associated with tetraphobia can vary, however, they can include: 

  1. Avoidance of the number 4 
  2. Obsessive thoughts about the number 4 
  3. Anxiety when exposed to the number 4

These symptoms are rather general, but it is recommended that if you experience any of the above, you get in contact with a psychiatrist soon for a diagnosis. Diagnosis is done through psychological evaluation. Phobias are treated as anxiety disorders and are placed in their own group, known as phobic disorders. There are several therapeutic options for anxiety disorders:8 

  1. Cognitive Behavioural Therapy 
  2. Drugs such as selective serotonin reuptake inhibitors (SSRIs), Serotonin and noradrenaline reuptake inhibitors (SNRIs), pregabalin, or benzodiazepines

Conclusive remarks

Superstitious beliefs and rituals such as tetraphobia are not peculiar to Asian people. Such practices and religious beliefs are universal and can be found among different cultures across the world. ‘Magical-religious’ thought patterns and beliefs are not peculiar to only a certain kind of people, the poor, the ignorant, or any other ‘so-called’ archetypes. Also, it is not an archaic tradition either. Rather, it is an integral component of humanity and is defined by our environment and character.9  In essence, we are surrounded by many human-curated orientations and rules that cannot be explained. Further studies need to be carried out to evaluate the effect of superstitions on human development and human interactions with the environment.7 


‘Tetraphobia’ is a word coined from the Greek words ‘Tetra’ and ‘Phobos’. These words are interpreted to mean ‘the number four’ and ‘the emotion of fear’, respectively. Tetraphobia is prominent among the people of Chinese cultures, particularly those who possess sino-Xenic vocabulary. The fear of the number four stems from the fact that in these languages, the word for four sounds very identical to the word for ‘death’. The association of these is the reason why the number is culturally associated with ‘evil’ or ‘bad luck’. It is not unusual to find out in these cultures that the number is deliberately skipped in the allocation of floor numbers in high-rise buildings. It is also not unusual to find that electronic / gadget manufacturing companies such as Samsung and Nokia seem to avoid identifying new gadget models with numbers that begin with the number four due to the predominant tetraphobia cultures in these regions.

Cultural superstitions and phobias such as this are not peculiar to the Chinese; they are a global phenomenon and are very diverse, from one cultural belief to another. Phobia originates from experiences between humans and their environments. Superstitions are not abnormal behaviours, nor are they limited to dark ages, level of education, race, religion, or financial status. Rather, they are evolutionary human attributes that develop from an inherent fear of unpredictable natural environments. Superstitions are more prevalent where there is a stressful or dangerous situation- a coping mechanism.

Phobias are understood to be anxiety disorders and thus are treated as such using psychological therapies such as cognitive behavioural therapy or with medications such as antidepressants.

In the course of this study, it was observed that there is a limited body of work focusing on the subject of tetraphobia and its prevalence in Chinese cultures and its effects on the lives of the Chinese who strongly believe in the concept of the number four, indicating bad luck.


  1. Kunwar R. Mathematics Phobia: Causes, Symptoms and Ways to Overcome. International Journal of Creative and Research Thoughts [Internet]. 2020 Aug [cited 2024 Mar 10];8(8). Available from: https://www.researchgate.net/publication/343655607_MATHEMATICS_PHOBIA_CAUSES_SYMPTOMS_AND_WAYS_TO_OVERCOME 
  2. Auer BR, Roottmann H. Is There a Friday the 13th Effect in Emerging Asian Stock Markets? 2013 [cited 2024 Mar 10]; Available from: https://www.econstor.eu/bitstream/10419/84151/1/cesifo_wp4409.pdf 
  3. Yau Hau Tse A. To Be or Not to Be Superstitious- That’s the Question. Procedia - Social and Behavioral Sciences [Internet]. 2015 Nov 20 [cited 2024 Mar 10];208:5–12. Available from: https://www.sciencedirect.com/science/article/pii/S1877042815055159 
  4. Sunarni N, Kurnia Firmansyah E, Abdul Malik Z, Rohmayani Y. CONTRASTIVE APPROACH TO NUMERIC USAGE IN JAPAN AND IN THE ABAJADUN METHOD. Humanities & Social Sciences Reviews [Internet]. 2020 Jun 17 [cited 2024 Mar 10];8(3):928–39. Available from: https://www.researchgate.net/publication/342274920_CONTRASTIVE_APPROACH_TO_NUMERIC_USAGE_IN_JAPAN_AND_IN_THE_ABAJADUN_METHOD#fullTextFileContent 
  5. Phillips DP, Liu GC, Kwok K, Jarvinen JR, Zhang W, Abramson IS. The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death. BMJ [Internet]. 2001 Dec 22 [cited 2024 Mar 10];323(7327):1443–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC61045/#:~:text=Conclusions,increases%20on%20psychologically%20stressful%20occasions
  6. Panesar NS, Chan NCY, Li SN, Lo JKY, Wong VWY, Yang IB, et al. Is four a deadly number for the Chinese? The Medical Journal of Australia [Internet]. 2003 Dec 1 [cited 2024 Mar 10];179(11):656–8. Available from: https://pubmed.ncbi.nlm.nih.gov/14636150/#:~:text=Background%3A%20The%20numbers%204%2C%2014 
  7. Mandal FB. Superstitions: A Culturally Transmitted Human behaviour. Scientific & Academic Publishing [Internet]. 2018 [cited 2024 Mar 10];8(4):65–9. Available from: http://article.sapub.org/10.5923.j.ijpbs.20180804.02.html 
  8. Ströhle A, Gensichen J, Domschke K. The Diagnosis and Treatment of Anxiety Disorders. Deutsches Ärzteblatt International [Internet]. 2018 Sep [cited 2024 Mar 10];115(37):611–20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206399/ 
  9. Martin del Campo Rios J. Religion and superstition through a cognitive perspective: examining the relationship of religious and superstitious beliefs to cognitive processes [Internet]. University of Leicester; 2015 [cited 2024Mar10]. Available from: https://hdl.handle.net/2381/32224 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Olajide Otuyemi

BPharm, Olabisi Onabanjo University, Nigeria; MPH University of Ilorin, Nigeria; MSc. Drug discovery, development, and delivery, Liverpool John Moores University, UK

Olajide Otuyemi is an experienced pharmacist and public health specialist with years of experience and a proven track record in the pharmaceutical industry and global health. His knowledge and experience spans across research, pharmaceuticals, patient education, and public health initiatives. He is passionate about health education and empowering others to make informed decisions to support positive health outcomes. He hopes to continue making high-quality medical information accessible and available to all.

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