Monk, NathanCunningham, RuthStanley, JamesCrengle, SueFitzjohn, JulieKerdemelidis, MelissaLockett, HelenMcLachlan, AndreWaitoki, WaikaremoanaLacey, Cameron2024-09-132024-09-132024Monk, N. J., Cunningham, R., Stanley, J., Crengle, S., Fitzjohn, J., Kerdemelidis, M., Lockett, H., McLachlan, A. D., Waitoki, W., & Lacey, C. (2024). The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study. Australian and New Zealand Journal of Psychiatry, -Online First, 1-14. https://doi.org/10.1177/000486742412709810004-8674https://hdl.handle.net/10289/16907Background: People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. Objective: Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. Methods: A cohort (N = 14,122) of young people (16–24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan–Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years. Results: In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan–Meier plots show hospitalisation and mortality inequities emerging approximately 4–7 years following first-episode psychosis diagnosis. Conclusions: Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/First-episode psychosis, New Zealand, Māori, indigenous health, health equity, physical health, cardiometabolic health, premature mortality, cohort studyFirst-episode psychosisMāoriNew Zealandcardiometabolic healthcohort studyhealth equityindigenous healthphysical healthpremature mortalityJournal Article10.1177/000486742412709811440-161432 Biomedical and Clinical Sciences3202 Clinical Sciences3202 Clinical sciences3 Good Health and Well Being