Which term describes invented or distorted words?

• A. Neologisms
• B. Derailment
• C. Incoherence
• D. Perseveration

Answer: (A)

Neologisms describe newly created or distorted words that the patient uses, which have no agreed meaning to others. In a mental status exam, this indicates a disruption in thought form—speech may be fluent in content but the actual words are nonsensical or meaningless to listeners. This is a hallmark of a formal thought disorder and is commonly seen in schizophrenia spectrum conditions or psychotic features of mood disorders. The idea here is that the patient isn’t just talking about strange topics; they’re producing words that don’t map to real language, which sets neologisms apart from other speech abnormalities. By contrast, derailment involves a rapid drift between topics, incoherence means the speech is incomprehensible due to disorganization, and perseveration is the sticking repetition of a word or idea.