Māori and non-Māori receive different mental health diagnoses, according to a national cohort study of youth with first episode psychosis occurring between 2009 and 2012. The study used a previously established cohort of more than 2400 13- to 25-yearolds, as well as anonymised routine mental health service data. Compared with non-Māori, Māori were more likely to be diagnosed with schizophrenia (51% vs 35%) and less likely to be diagnosed with bipolar disorder (18% vs 28%) over the 5-year observation period. Stability of diagnosis was similar between ethnic groups, and those with no stable diagnosis at first episode psychosis were most likely to move towards a schizophrenia disorder diagnosis in both groups. Māori had a lower rate of diagnosed comorbid affective and anxiety symptoms compared with non-Māori, and higher rates of continued face-to-face contact and inpatient admission across all diagnoses. Ethnic differences in schizophrenia and affective psychosis diagnoses could be related to differential exposure to socio-environmental risk or assessor bias, the study authors speculated.