{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T20:55:55Z","timestamp":1769720155317,"version":"3.49.0"},"reference-count":63,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["GSB 171373"],"award-info":[{"award-number":["GSB 171373"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Autism and borderline personality disorder (BPD) are each associated with increased psychiatric emergency department (PsyED) use, yet the service impact of coexisting autism\u2013BPD remains unclear. We conducted a retrospective chart review of 1027 PsyED visits by 345 autistic adults (2018\u20132020) 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\u2010effects logistic regression. BPD was documented in 33.5% of visits and in 11.0% of unique autistic individuals, more often in birth\u2010assigned females. Among all autistic individuals' PsyED visits, an autism diagnosis was documented in 60.2% of their text\u2010based 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\u20137.169;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). No significant differences were observed in disposition (discharge vs. admission) or restraint use between birth\u2010assigned sex, BPD status, or documentation of autism within the visit. Findings underscore the need for sex\u2010sensitive, autism\u2010aware assessments and trauma\u2010informed care in PsyED settings, and caution against diagnostic overshadowing that influences clinical decision\u2010making. Limitations include a single\u2010site 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\u2013BPD care pathways, with specialized outpatient supports, sensory\u2010friendly adaptations, and structured referrals, may improve care and reduce PsyED visits.\n                  <\/jats:p>","DOI":"10.1002\/aur.70148","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T10:10:14Z","timestamp":1763633414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychiatric Emergency Visits of Autistic Adults With or Without Documented Borderline Personality Disorder"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1121-8991","authenticated-orcid":false,"given":"Ching\u2010Hua Julie","family":"Lee","sequence":"first","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Tsaotun Psychiatric Center, Ministry of Health and Welfare  Tsao\u2010Tun Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louisa Lok Yee","family":"Man","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Morra","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carleigh","family":"Pace\u2010Tonna","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychology, Faculty of Arts and Science University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantelle","family":"Castelino","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychology University of Waterloo  Waterloo ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Courchesne","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"D\u00e9partement de Psychologie Universit\u00e9 de Montr\u00e9al  Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margot","family":"Frayne","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychology, Faculty of Arts and Science University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Luk","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Michael G. DeGroote School of Medicine McMaster University  Hamilton ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paria","family":"Baharikhoob","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Jachyra","sequence":"additional","affiliation":[{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Sport and Exercise Sciences Durham University  Durham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juveria","family":"Zaheer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"},{"name":"General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie H.","family":"Ameis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"},{"name":"Cundill Centre for Child and Youth Depression, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Child and Youth Psychiatry Division, Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiang\u2010Yuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Sawyer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"},{"name":"Child and Youth Psychiatry Division, Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-9728","authenticated-orcid":false,"given":"Yona","family":"Lunsky","sequence":"additional","affiliation":[{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9593-5508","authenticated-orcid":false,"given":"Meng\u2010Chuan","family":"Lai","sequence":"additional","affiliation":[{"name":"Margaret and Wallace McCain Centre for Child, Youth &amp; Family Mental Health, Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health  Toronto ON Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine University of Toronto  Toronto ON Canada"},{"name":"Department of Psychology, Faculty of Arts and Science University of Toronto  Toronto ON Canada"},{"name":"Child and Youth Psychiatry Division, Centre for Addiction and Mental Health  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10060992"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.07.047"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13229\u2010023\u201000580\u20103"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000173701"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1320546"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.13970"},{"key":"e_1_2_12_9_1","first-page":"864","article-title":"Characterizing Autism Spectrum Disorder and Predicting Suicide Risk for Pediatric Psychiatric Emergency Services Encounters","volume":"2023","author":"Brown K. A.","year":"2023","journal-title":"AMIA Annual Symposium Proceedings"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci14010037"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/15579883241271894"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613231223626"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.16m11100"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000361"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi_2018_32_400"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.102080"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2022.0088"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13060862"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2023.0006"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psychotherapy.20230049"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/2040\u20102392\u20104\u201049"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613211060906"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.731629"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/15248380231213314"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010020\u201002531\u20101"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010021\u201004969\u2010y"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010014\u20102251\u20102"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs14080669"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613221088073"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20104642(23)00221\u20103"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(15)00277\u20101"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000770"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2014.10.003"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.27415"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(04)16770\u20106"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010016\u20102953\u20108"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613241299285"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010017377"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.17r11506"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep10418"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2619"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010014\u20102188\u20105"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20m13833"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010011\u20101289\u20107"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.9.1199"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40653\u2010019\u201000253\u20105"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13118"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279015"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.24br03776"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjop.12731"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010049437V"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2017.00136"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1490157"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010014\u20102183\u2010x"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010021\u201004932\u2010x"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613241276073"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1177\/15248380221093689"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12580"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/22.089"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1080\/13651501.2023.2187843"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1521\/psyc.2010.73.3.277"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.856084"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.35241"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2024.80"}],"container-title":["Autism Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.70148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/aur.70148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.70148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:19:01Z","timestamp":1769678341000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/aur.70148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":63,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/aur.70148"],"URL":"https:\/\/doi.org\/10.1002\/aur.70148","archive":["Portico"],"relation":{},"ISSN":["1939-3792","1939-3806"],"issn-type":[{"value":"1939-3792","type":"print"},{"value":"1939-3806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"2025-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70148"}}