A patient uses an unusual, non-standard word. Before revealing the answer, decide what distinguishes a neologism from a paraphasia.

Ask about the underlying cause of the word's disturbance: is it arising from psychotic thought content, or from a language disorder such as aphasia? A neologism arises from psychotic thought content — a wholly new word, or an existing word used with an idiosyncratic meaning, often serving some private purpose for the patient. A paraphasia arises from a language disorder such as aphasia, reflecting a breakdown in the mechanics of word retrieval or production rather than psychotic content. The surface appearance — an unusual or wrong-sounding word — can look similar, but the underlying process, and therefore the rest of the clinical picture to look for, differs substantially.