para Symfony 2 use sql bruto:
$em->getConnection()->prepare("INSERT INTO table SET
some_fields = "some data", created_at = NOW()
ON DUPLICATE KEY UPDATE
some_fields = "some data", updated_at = NOW()
")->execute();
$em->getConnection()->prepare("INSERT INTO table SET
some_fields = "some data", created_at = NOW()
ON DUPLICATE KEY UPDATE
some_fields = "some data", updated_at = NOW()
")->execute();