Consultations aux urgences psychiatriques d’adultes autistes avec ou sans trouble de la personnalité borderline documenté

Titre original en anglais : Psychiatric Emergency Visits of Autistic Adults With or Without Documented Borderline Personality Disorder

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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Lee, C. H. J., Man, L. L. Y., Morra, A., Pace‐Tonna, C., Castelino, C., Courchesne, V., Frayne, M., Luk, V., Baharikhoob, P., Jachyra, P., Zaheer, J., Ameis, S. H., Lin, H., Sawyer, A., Lunsky, Y., & Lai, M. C. (2025). Psychiatric Emergency Visits of Autistic Adults With or Without Documented Borderline Personality Disorder. Autism Research, 19(1), e70148-e70148. https://doi.org/10.1002/aur.70148

Date de publication: 20/11/2025 Ajout dans AutiHub: 24/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
16
Auteur·ices de la publication identifié·es comme autistes
1 / 16 (6,2 %)
  1. Ching-Hua Julie Lee
  2. Louisa Lok Yee Man
  3. Alexandra Morra
  4. Carleigh Pace‐Tonna *
  5. Chantelle Castelino
  6. Valerie Courchesne
  1. Margot Frayne
  2. Vanessa Luk
  3. Paria Baharikhoob
  4. Patrick Jachyra
  5. Juveria Zaheer
  6. Stephanie H. Ameis
  1. Hsiang‐Yuan Lin
  2. Amanda Sawyer
  3. Yona Lunsky
  4. Meng-Chuan Lai

Résumé

RÉSUMÉ L’autisme et le trouble de la personnalité borderline (TPB) sont chacun associés à une utilisation accrue des services d’urgences psychiatriques (PsyED), mais l’impact sur les services de la coexistence de l’autisme et du TPB reste incertain. Nous avons réalisé une revue rétrospective des dossiers de 1 027 consultations PsyED de 345 adultes autistes (2018–2020) dans un hôpital psychiatrique canadien urbain afin de comparer les modalités de service entre les personnes avec et sans diagnostic de TPB. Les caractéristiques sociodémographiques, les motifs de consultation, le recours à la contention et l’orientation ont été analysés au moyen d’une régression logistique à effets mixtes. Un TPB était documenté lors de 33,5 % des consultations et chez 11,0 % des personnes autistes uniques, plus souvent chez les personnes de sexe féminin assigné à la naissance. Parmi toutes les consultations PsyED des personnes autistes, un diagnostic d’autisme était documenté dans 60,2 % de leurs dossiers textuels. En outre, l’autisme était documenté moins fréquemment lorsque le TPB était consigné, ce qui suggère une possible occultation diagnostique. La suicidalité comme motif principal de consultation était associée à un TPB documenté (OR 4.366, IC à 95 % 2.659–7.169 ; p < 0.001). Aucune différence significative n’a été observée concernant l’orientation (sortie vs admission) ou le recours à la contention selon le sexe assigné à la naissance, le statut TPB ou la documentation de l’autisme au cours de la consultation. Les résultats soulignent la nécessité d’évaluations sensibles au sexe et tenant compte de l’autisme, ainsi que de soins tenant compte des traumatismes dans les contextes PsyED, et appellent à la prudence face à l’occultation diagnostique qui influence la prise de décision clinique. Les limites comprennent un échantillon provenant d’un seul site et l’absence de données sur le moment du diagnostic d’autisme, empêchant les inférences temporelles. Les travaux futurs devraient évaluer des interventions ciblées et clarifier les mécanismes de la suicidalité chez les personnes autistes présentant un TPB concomitant. Des parcours de soins intégrés autisme–TPB, avec des soutiens ambulatoires spécialisés, des adaptations favorables aux sensibilités sensorielles et des orientations structurées, pourraient améliorer les soins et réduire les consultations PsyED.

ABSTRACT Autism and borderline personality disorder (BPD) are each associated with increased psychiatric emergency department (PsyED) use, yet the service impact of coexisting autism–BPD remains unclear. We conducted a retrospective chart review of 1027 PsyED visits by 345 autistic adults (2018–2020) at an urban Canadian psychiatric hospital to compare service patterns between those with and without a BPD diagnosis. Sociodemographics, presenting reasons, restraint use, and disposition were analyzed using mixed‐effects logistic regression. BPD was documented in 33.5% of visits and in 11.0% of unique autistic individuals, more often in birth‐assigned females. Among all autistic individuals' PsyED visits, an autism diagnosis was documented in 60.2% of their text‐based charts. Furthermore, autism was documented less frequently when BPD was recorded, suggesting possible diagnostic overshadowing. Suicidality as the primary reason for visit was associated with documented BPD (OR 4.366, 95% CI 2.659–7.169; p < 0.001). No significant differences were observed in disposition (discharge vs. admission) or restraint use between birth‐assigned sex, BPD status, or documentation of autism within the visit. Findings underscore the need for sex‐sensitive, autism‐aware assessments and trauma‐informed care in PsyED settings, and caution against diagnostic overshadowing that influences clinical decision‐making. Limitations include a single‐site sample and lack of autism diagnosis timing data, precluding temporal inferences. Future work should test targeted interventions and clarify mechanisms of suicidality among autistic individuals with coexisting BPD. Integrated autism–BPD care pathways, with specialized outpatient supports, sensory‐friendly adaptations, and structured referrals, may improve care and reduce PsyED visits.

Bibliographie citée par cette référence

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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
64
Avec un DOI
63
Sans DOI, à partir du texte brut de la bibliographie
1
3 / 64 (4,7 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
0 / 64 (0,0 %)
Références avec noms d’auteurices détectés
64 / 64 (100,0 %)
Sans nom d’auteurice détecté
0
Sans titre structuré
0
Sans identifiant stable
1
Références avec noms bruts d’auteurices restant à vérifier
0
Références avec problème de récupération des métadonnées externes
0
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
348
À partir du DOI ou de métadonnées externes
348
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
0
71 / 348 (20,4 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 277 / 348 (79,6 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
6 / 348 (1,7 %)
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 : 6 / 71 (8,5 %). Personnes distinctes identifiées comme autistes : 5 / 314 (1,6 %).
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