En temps de besoin : consultations aux urgences psychiatriques chez les adultes autistes

Titre original en anglais : In Times of Need: Psychiatric Emergency Department Presentations in Autistic Adults

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». un auteur·ice de cette publication est identifié·e comme autiste dans le projet.

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Courchesne, V., Frayne, M., Castelino, C., Luk, V., Man, L. L. Y., Lee, C. H. J., Baharikhoob, P., Pace‐Tonna, C., Jachyra, P., Ameis, S. H., Lin, H., Sawyer, A., Zaheer, J., Lunsky, Y., & Lai, M. C. (2026). In Times of Need: Psychiatric Emergency Department Presentations in Autistic Adults. Autism in Adulthood. https://doi.org/10.1177/25739581251415125

Date de publication: 22/01/2026 Ajout dans AutiHub: 24/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
15
Auteur·ices de la publication identifié·es comme autistes
1 / 15 (6,7 %)
  1. Valerie Courchesne
  2. Margot Frayne
  3. Chantelle Castelino
  4. Vanessa Luk
  5. Louisa Lok Yee Man
  1. Ching-Hua Julie Lee
  2. Paria Baharikhoob
  3. Carleigh Pace‐Tonna *
  4. Patrick Jachyra
  5. Stephanie H. Ameis
  1. Hsiang‐Yuan Lin
  2. Amanda Sawyer
  3. Juveria Zaheer
  4. Yona Lunsky
  5. Meng-Chuan Lai

Résumé

Contexte : Les personnes autistes présentent une plus grande vulnérabilité aux difficultés de santé mentale que la population générale, mais elles n'ont pas accès à des soins de santé mentale adéquats. Les obstacles à la recherche et à l'obtention de soins de santé mentale adéquats, tels que le stress lié au statut de minorité, les événements de vie défavorables, la discrimination et la stigmatisation, peuvent entraîner un recours accru aux services d'urgences générales et psychiatriques (ED/PsyED) lors de crises de santé mentale. Toutefois, peu de recherches décrivent l'utilisation des PsyED chez les adultes autistes. Méthodes : Cette vaste revue rétrospective de dossiers a analysé les consultations aux PsyED d'adultes autistes (âgés de 16 à 63 ans) dans un hôpital psychiatrique urbain au Canada de 2018 à 2020. Les données ont été recueillies auprès de 345 patients autistes ayant effectué 1027 consultations aux PsyED au cours de cette période de 3 ans. Les informations démographiques, les diagnostics psychiatriques et neurodéveloppementaux, ainsi que les motifs de consultation aux PsyED ont été caractérisés. Les prédicteurs des motifs de consultation aux PsyED ont été examinés au moyen de régressions logistiques à effets mixtes. Les différences entre les personnes ayant consulté une seule fois et les personnes ayant consulté de façon récurrente ont été explorées. Résultats : Les patients autistes étaient majoritairement blancs (56,2 %), citoyens canadiens (79,1 %), hétérosexuels (50,7 %) et assignés de sexe masculin à la naissance (72,2 %). Beaucoup avaient un faible statut socioéconomique, un tiers gagnant moins de 15 000 dollars canadiens par an. La plupart (84,3 %) présentaient au moins une affection concomitante de santé mentale, et 54,8 % en présentaient deux ou plus. Les taux de trouble déficitaire de l'attention avec hyperactivité et de déficience intellectuelle étaient tous deux d'environ 20 %. Les motifs de consultation les plus fréquents comprenaient la suicidalité (42,9 %), l'agressivité (24,6 %) et les symptômes de l'humeur (16,1 %). Les motifs de consultation aux PsyED étaient associés à des diagnostics spécifiques de santé mentale et neurodéveloppementaux. Les personnes ayant consulté de façon récurrente (40,3 %) ne différaient pas des personnes ayant consulté une seule fois sur le plan des caractéristiques sociodémographiques, mais présentaient des tableaux cliniques plus complexes. Conclusion : Les besoins de santé mentale des adultes autistes étaient élevés et complexes dans le contexte des PsyED, particulièrement chez ceux nécessitant des consultations d'urgence récurrentes. Il est essentiel de combler les lacunes des services et les obstacles au soutien continu en santé mentale afin d'améliorer la continuité des soins.

Background: Autistic individuals exhibit greater vulnerability to mental health challenges than the general population, yet they lack access to adequate mental health care. Barriers to seeking and receiving adequate mental health care, such as minority stress, adverse life events, discrimination, and stigmatization can result in increased reliance on general and psychiatric emergency departments (ED/PsyED) during mental health crises. There is however limited research detailing PsyED use in autistic adults. Methods: This large-scale retrospective chart review analyzed PsyED visits by autistic adults (aged 16 to 63) in an urban psychiatric hospital in Canada from 2018 to 2020. Data were collected from 345 autistic patients who had 1027 PsyED visits during this 3-year period. Demographic information, psychiatric and neurodevelopmental diagnoses, and reasons for PsyED visits were characterized. Predictors of reasons for visiting PsyED were examined using mixed-effects logistic regressions. Differences between single-time and recurrent visitors were explored. Results: Autistic patients were mostly white (56.2%), Canadian citizens (79.1%), heterosexual (50.7%), and assigned male at birth (72.2%). Many were of low socioeconomic status, with one-third earning less than 15,000 Canadian dollars yearly. Most (84.3%) had at least one co-occurring mental health condition, with 54.8% having two or more. Rates of attention-deficit/hyperactivity disorder and intellectual disability were both around 20%. Most frequent reasons for visits included suicidality (42.9%), aggression (24.6%), and mood symptoms (16.1%). Reasons for visiting PsyED were associated with specific mental health and neurodevelopmental diagnoses. Recurrent visitors (40.3%) did not differ in sociodemographic characteristics from single-time visitors, but had more complex clinical presentations. Conclusion: Mental health needs of autistic adults were high and complex in the PsyED setting, particularly those needing recurrent emergency visits. Addressing service gaps and barriers to ongoing mental health support is essential to enhance the continuity of care.

Bibliographie citée par cette référence

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Vue d’ensemble de la bibliographie citée

Ces indicateurs décrivent la bibliographie citée par cette publication. Un nom d’auteurice est compté chaque fois qu’il apparaît dans une référence citée : une même personne peut donc être comptée plusieurs fois. Les noms qui ne sont pas encore associés à un·e auteurice déjà présent·e dans AutiHub sont traités comme inconnus, pas comme non autistes. Dernier calcul : 02/10/2026 01:01.

Références citées
91
Avec un DOI
85
Sans DOI, à partir du texte brut de la bibliographie
6
7 / 91 (7,7 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
4 / 91 (4,4 %)
Références avec noms d’auteurices détectés
87 / 91 (95,6 %)
Sans nom d’auteurice détecté
4
Sans titre structuré
4
Sans identifiant stable
6
Références avec noms bruts d’auteurices restant à vérifier
4
Références avec problème de récupération des métadonnées externes
1
Ces indicateurs portent sur les références citées affichées sur cette page, après fusion des doublons techniques. Une référence sans DOI peut quand même soutenir les statistiques d’auteurices lorsqu’un titre et des noms d’auteurices sont disponibles.
Noms d’auteurices détectés dans la bibliographie citée
496
À partir du DOI ou de métadonnées externes
496
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
4
133 / 496 (26,8 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 363 / 496 (73,2 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
18 / 496 (3,6 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 18 / 133 (13,5 %). Personnes distinctes identifiées comme autistes : 17 / 462 (3,7 %).
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