Neologism: The Term for Making Up Words in Psychotic Disorders
The phenomenon of a psychiatric patient making up new words is called "neologism," which represents a specific manifestation of formal thought disorder commonly seen in schizophrenia and other psychotic conditions.
Definition and Clinical Context
Neologisms are newly created words or expressions that have meaning only to the patient, representing a disruption in normal language and conceptual processing 1, 2.
This phenomenon falls under the broader category of formal thought disorder (FTD), which encompasses various abnormalities in the form and flow of thought as expressed through speech 3, 2.
Related Language Abnormalities in Psychotic Disorders
While neologisms represent word creation, several related language disturbances occur in schizophrenia:
"Peculiar word use" refers to using existing words in unusual or idiosyncratic ways, which is distinct from creating entirely new words 4, 1.
Peculiar word use is significantly more common in first-episode psychosis patients compared to healthy controls, and it persists even when controlling for education, family history, and substance use 1.
Children with schizophrenia characteristically display loose associations, illogical thinking, and impaired discourse skills rather than high rates of incoherence or poverty of speech 5, 3.
Underlying Mechanisms
Neologisms and peculiar word use appear to stem from deficits in semantic processing, with patients relying more heavily on phonologic (sound-based) rather than semantic (meaning-based) associations 4.
The severity of peculiar word use correlates with the degree of formal thought disorder and the tendency to use phonologic rather than semantic associations in both patients with schizophrenia and their unaffected siblings 4.
Reduced attention is the strongest predictor of language dysfunction in thought-disordered schizophrenic patients, suggesting that attentional deficits contribute to these language abnormalities 6.
Critical Diagnostic Considerations
When evaluating apparent neologisms or peculiar language in children and adolescents:
Differentiate true thought disorder from developmental delays or primary language disorders, as developmental differences in language and cognition affect symptom presentation 5, 3.
Cultural and intellectual factors must be considered in the diagnostic assessment, as what appears peculiar may reflect cultural or developmental variations rather than psychopathology 3.
In children, assess whether language abnormalities represent psychotic thought disorder versus autism spectrum disorder or pervasive developmental disorders, which should be considered distinct from schizophrenia 5.
Common Pitfall to Avoid
- Do not confuse a child's vivid imagination, creative language play, or age-appropriate linguistic experimentation with pathological neologisms—true neologisms in psychotic disorders lack insight, persist despite correction, and are associated with other signs of formal thought disorder and functional impairment 7.