False Psychosis: The Affective Boundary State Preceding Schizoaffective Disorder -A Border Zone Model (DBZM)

Background: The classical distinction between obsessive-compulsive disorder (OCD), bipolar spectrum disorders, and psychotic disorders fails to explain a frequently observed but poorly recognized affective-cognitive state characterized by intrusive, ego-dystonic pseudo-psychotic phenomena. These include intrusive suicidal imperatives, "window fear," pre-delusional fixation, and partial erosion of reality-testing without transition into true psychosis. Objective: To propose a new diagnostic and mechanistic construct, termed "False Psychosis," described as the final pre-schizoaffective boundary state where obsessive, affect-driven cognitive intrusions acquire psychotic phenomenology while maintaining ego-dystonicity and full external reality testing. Method: The model integrates glutamatergic (NMDA-AMPA), dopaminergic, and affective circuits with phenomenological markers and longitudinal risk transitions based on contemporary neuroscience literature. Conclusion: "False Psychosis" represents a stable and clinically relevant zone between severe OCD with poor insight and schizoaffective disorder, requiring dedicated early-intervention algorithms to prevent transition to frank psychosis.