AIMS: The aim is to highlight adoptees' and stepchildren's psychiatric contact and diagnoses compared with non-adoptees. METHODS: The setting is Greenland and the methodology is a comparative in-ward patient register-based study. The background is the Greenlandic tradition for adoption and community child care and international research stressing that adoptees demonstrate adverse health outcomes. The cohort is in-ward patients (>24 hours), born between 1973 and 2005. Correlation between various dependent and independent variables are analyzed. The research makes different comparative statements of psychiatric admissions and diagnoses related to adoptees and stepchildren compared to non-adoptees with respect to demographic and socioeconomic indicators. The psychiatric data material is collected from 1992 to 2008 and the socioeconomic indicators are included from 1996. RESULTS: The findings show, contrary to findings related to adoptees in Western societies, that being an adoptee in Greenland does not increase the risk for psychiatric admission, but being a "female stepchild" does. The adjusted risk for adoptees is "non-significant" at 1.1 (95% confidence interval (95% CI) 0.6-1.9) but the adjusted risk for female stepchildren is "significant" at 3.4 (95% CI 1.8-6.6). The most frequent diagnosis is "Inherent or acquired brain suffering". The findings open up possibilities for new hypotheses as to reasons for adoptees' adverse health outcomes in the Western world. CONCLUSIONS: Epidemiological and medical contact recording do not exist outside central hospital level in Greenland, therefore, in order to put psychiatric contact patterns into perspective, in-depth field studies are required in close collaboration with the local Greenlandic population.