État de la question: La prévalence des troubles de personnalité borderline (TPB) en population de suicidant est élevée (10 à 55 %). Ces patients présentent à la fois des récidives suicidaires plus fréquentes et un pronostic psychosocial plus péjoratif. Cependant, l'utilité du diagnostic de TPB porté à l'accueil aux urgences, dans la mise en place d'un plan de traitement spécifique, n'a jamais été étudiée. Objectif: Évaluer l'association entre un diagnostic de TPB chez les patients suicidants et l'orientation mise en place depuis les urgences. Méthode: Étude cas-témoin portant sur une inclusion de dix mois, de 478 patients admis suite à un abus médicamenteux sévère aux urgences de l'hôpital général. Le recueil des données se fait à partir de fiches anonymes remplies par le clinicien. Résultats: Sur 478 patients admis aux urgences pour intoxication médicamenteuse volontaire, 99 (22,6 %) présentent un TPB selon les cliniciens. Ils se distinguent, par rapport aux autres patients suicidants, sur des caractéristiques démographiques, un plus grand recours aux soins psychiatriques, des antécédents de tentative de suicide plus fréquents et des intoxications aux neuroleptiques plus fréquentes. Aucune différence en ce qui concerne leur orientation au décours des urgences n'a été mise en évidence. Conclusion: Les patients suicidants souffrant d'un TPB présentent plus de critères de sévérité, sans que cela influence l'orientation depuis les urgences. BACKGROUND: Management of suicide attempters accounts for 10% of the psychiatric activity in the emergency room. In this population, the prevalence of borderline personality disorder (BPD) is high (10 - 55%). These patients present poorer psychosocial outcome and more frequent suicide attempts repetitions. However, the utility of the assessment of BPD in the referral to a specific treatment plan has not been yet studied. OBJECTIVE: To examine the association between the assessment of a diagnosis of BPD after a suicide attempt and the referral from the emergency room to a specific treatment plan. HYPOTHESIS: Suicide attempters with BPD, according to clinicians diagnosis, differ in terms of severity from those without more risk factors of suicide attempt repetitions and poorer psychosocial functioning, and in psychiatric referral from the emergency room. METHOD: Our case-control study took place during 10 months in the Geneva general hospital. We continuously enrolled patients admitted to the emergency room for deliberate self poisoning and separated them into two groups (BPD and control) according to the clinician's diagnosis. Data from medical records were systemically and anonymously gathered. We compared BPD patients' socio-demographic and clinical characteristics, as well as psychiatric referral, with the control group. RESULTS: Of the 478 subjects admitted to the emergency room for deliberate self-poisoning, 99 (22.6%) were diagnosed BPD by clinicians. Compared to controls, they were more frequently female (OR=3.9) and living alone (OR=3.8) and more often resorted to psychiatric care (OR=2.9), notably to emergency care (OR=3.8). Past history of suicide attempt was also more frequent (OR=1.9) as was the use of neuroleptics in the attempt (OR=2.7). No difference was detected in terms of psychiatric referral after emergency room care. CONCLUSION: Even if borderline personality disorder in suicide attempters is associated with more severity criteria, it is not associated with a referral to a specific treatment plan.