Table 1.
Study characteristics of included studies.
| Author(s), year | Country(ies) & Data period | Outcome | Sample/population and/or number of cases | Study design | Data collection & sources |
|---|---|---|---|---|---|
| Aghanwa, 2000 [35] | Fiji, Suva (15th January, 1999 – 14th January, 2000) | Suicide attempts (SA) | N=39 suicide attempts & N=67 other patients as controls | Case-control study | Consecutive cases of attempted suicide from the Colonial War Memorial Hospital, Suva, Fiji were evaluated within 24h of the receipt of the referrals by the consultant psychiatrist; controls - other psychiatric patients |
| Aghanwa, 2001 [36] | Fiji, Suva (January 1999 - December 2000) | SA | N=58 deliberate self-poisoning (of 68 SA) | Case series | Patients with Deliberate self-poisoning (DSP) from the Colonial War Memorial Hospital, Suva, Fiji. |
| Aghanwa, 2004 [5] | Fiji, Suva (1st January, 1999-30th June, 2002) | SA | N=128 suicide attempts | Case series | People who attempted suicide seen by the consultation-liaison psychiatric service in Colonial War Memorial Hospital in Suva, Central/Eastern of Fiji |
| Amadeo et al., 2015 [34] | French Polynesia (2008-2010) | SA | N=200 (of 515 hospital presentations): 100 in the intervention and 100 in treatment as usual | RCT | Testing brief intervention contact (BIC) in reducing NFSB. Of 515 persons admitted for presentations of NSFB to the ED of the Hospitalier de Polynésie Française |
| Amadeo et al., 2016 [23] | French Polynesia (2008-2010) | SA | N=556 hospital presentations (by 515 people) | Case series | Surveillance of admitted NFSB cases to the Emergency Department of the French Polynesia Hospital (Centre Hospitalier de Polynésie Française); 2012 Census data were used to calculate rates by specific socio-demographic groups. |
| Booth, 1999a [3] | Fiji (1982-83, 86, 89-90), Vanuatu (1990-1992), Micronesia (1960-1987), Federated States of Micronesia (1988-92), Marshall Islands (1988-1992 and 1992-1993), Tonga (1971-1982), Western Samoa (1981-83, 1988-92), American Samoa (1990-1991), Papua New Guinea (1990), Guam (1988-1992) | Suicide | Population of respective countries | Ecological study | Monitoring of published and unpublished official records obtained from health, police and vital registration authorities. Secondary sources comprise data reported in existing studies, which are re-analysed (Deoki 1987, Hezel 1987, 1989, Bowles 1985, Finau & Lasalo 1985). Age standardisation using World population (WHO 1995). |
| Booth, 1999b [55] | Western Samoa (1981, 1988-1991), Fiji (1982-83, 1989-1990) | Suicide | Population of respective countries | Ecological study | Monitoring of published (Deoki 1987, Bowles 1985) and unpublished health, coroners' and police records. |
| Booth, 2010 [6] | Guam (1971, 1974-2006) | Suicide | Population of respective country | Ecological study | Monitoring of published mortality data from Department of Public Health and Social services by cause of death for 1971, 1974-2003. |
| Bridges, 2008 [4] | The Cook Islands, Federated States of Micronesia, Fiji Islands, Marshall Islands, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu (2002 or closest year) | Suicide | Population of respective countries | Ecological study | The age-standardised rates of suicide from the WHO mortality database. |
| De Leo et al., 2013 [24] | Fiji (2004-2009), Tonga (1979-2009), Vanuatu (2010), French Polynesia (1999, 2003, 2005-2007) | Suicide & SA | Suicide: N=455 (Fiji); N=120 (Tonga); N=2 (Vanuatu); N=155 (French Polynesia) SA: N=646 (Fiji); N=19 (Tonga); N=10 (Vanuatu); N=557 (French Polynesia) |
Case series | SA surveillance in Fiji (St Giles Hospital - a psychiatric hospital), French Polynesia (Taaone Hospital Tahiti), Tonga (Tongatapu Main Hospital) and Vanuatu (Vila Central Hospital) Suicide surveillance from Fiji (Central Police Department); French Polynesia (National Police Department); Guam (Office of the Chief Medical Examiner), Tonga (Police Department, Tongatapu) and Vanuatu (Ministry of Health). |
| Devries et al., 2011 [56] | Samoa (2000-2003) | SA | N=1438 (Samoa) | Cross-sectional study | Secondary analysis of a WHO multi-country prevalence study investigating women's health and domestic violence using a national sample from Samoa of women aged 15-49 years. Participants were asked about lifetime suicide attempts. |
| Goodfellow et al., 2020 [49] | New Caledonia (2014-2015) | Suicide | N=52 suicides (out of 75 identified cases) | Case series | Psychological autopsies with family members of decedents identified via the Justice Department of New Caledonia |
| Haynes, 1984 [37] | Macuata - one of Fiji's provinces (1979-1982) and all Fiji (1981-1982) | Suicide | N=79 suicides | Case series | Surveillance of all suicide verdict in Macuata province specifically from the Police Register of Unnatural Deaths (1979-1982) (main data source). Supplementary data were obtained from medical records at Labasa Hospital. Police headquarters provided data for the whole of Fiji for 1981-82 (used only for rate comparisons). |
| Henson et al., 2012 [38] | Fiji (January 2010-December 2010) | SA | N=153 counselling referrals for suicide attempts & N=5,438other counselling referrals as controls | Case-control study | Secondary analysis of archived de-identified data collected for clinical and program evaluation purposes by Pacific Counselling & Social Services of Fiji. As this data were archival, the nature of the specific interventions is not known. Data from 4 regional hospitals in Fiji. Controls - other hospitalised patients. |
| Herman et al., 2016 [46] | Fiji, Vitu Levu (12 months concluding 30th September, 2006) | Suicide & SA | N=35 suicides (of 63 fatal injuries) N=60 non-fatal self-harm (of 452 non-fatal injuries) |
Case series | Surveillance of fatal and non-fatal intentional self-injury using The Fiji Injury Surveillance in Hospitals system (established at all hospitals in Viti Levu as part of the Traffic-Related Injury in the Pacific project). Cases were identified from hospital accident and emergency registers, admission and post-mortem records. TRIP-15. |
| Kushal et al., 2021 [20] | Cook Islands (2015), Fiji (2016), French Polynesia (2015), Kiribati (2011), Niue (2010), Samoa (2011), Solomon Islands (2011), Tokelau (2014), Tuvalu (2013), Vanuatu (2011), Wallis Futuna (2015) | SA | N=350 of 366 (Cook Islands); N=1303 of 1537 (Fiji); N=1732 of 1902 (French Polynesia); N=1253 of 1340 (Kiribati); N=73 of 82 (Niue); N=1259 of 2200 (Samoa); N=799 of 925 (Solomon Islands); N=75 of 85 (Tokelau); N=598 of 679 (Tuvalu); N=798 of 852 (Vanuatu); N=604 of 718 (Wallis Futuna) All aged 12-18 years |
Cross-sectional study | Secondary analysis of the Global School-Based Health Survey (GSHS) which uses a two-stage cluster sample design of school going adolescents, self-completed questionnaire, countries that included a question ‘During the past 12 months, did you actually attempt suicide?’ were analysed. |
| Liu et al., 2018 [19] | Kiribati (2011), Niue (2010), Samoa (2011), Solomon Islands (2011), Tuvalu (2013), Vanuatu (2011) | SA | N=1555 (Kiribati); N=134 (Niue); N=2303 (Samoa); N=1293 (Solomon Islands); N=899 (Tuvalu); N=1014 (Vanuatu) Reported response rate varied from 93.7% Samoa – 100% Niue All aged 12-18 years |
Cross-sectional study | Secondary analysis of the GSHS (see above). |
| Lowe, 2019 [7] | Federated States of Micronesia (1990-1999) | Suicide | N=74 suicides | Ecological study | Monitoring suicide reports in each village or municipality based on the Micronesian Seminar to calculate the 10-year average (1990-99) suicide rates per 100,000 on municipality level. |
| Peiris-John et al., 2013 [39] | Fiji, Viti Levu (12 months commencing 1st October 2005) | Suicide & SA | N=16 suicides by poisoning N=82 non-fatal intentional self poisonings |
Case series | Surveillance of fatal and non-fatal intentional self-injury by poisoning using The Fiji Injury Surveillance in Hospitals system (established at all hospitals in Viti Levu as part of the Traffic-Related Injury in the Pacific project). Cases were identified from hospital accident and emergency registers, admission and post-mortem records. TRIP-11. |
| Peltzer & Pengpid, 2015 [58] | Kiribati, Samoa, Solomon Islands, Vanuatu (2011) | SA | N=6540 school-going adolescents “predominantly” aged 13-16 years old (summed across all Pacific Island) | Cross-sectional study | Secondary analysis of the GSHS (see above). |
| Pengpid & Peltzer, 2020 [59] | Tonga (2017) | SA | N=3333 school-going adolescents (Mean age 14 years, IQR=3) | Cross-sectional study | Secondary analysis of the GSHS (see above). |
| Pengpid & Peltzer, 2020 [60] | Kiribati (2015-2016) | SA | N=2156 adults aged 18-69 years | Cross-sectional study | Secondary analysis of 2015-2016 Kiribati STEPS survey. The survey utilised a 3-stage cluster sampling strategy and was targeted at community-based adults. |
| Pinhey & Millman, 2004 [47] | Guam (2001) | SA | N=1381 (response rate of 96.6%) | Cross-sectional study | Secondary analysis of Guam's Youth Risk Behaviour Survey, sampling frame consisted of 4 public high schools and 3 Catholic high schools in Guam where youth were asked, “During the past 12 months did you actually attempt suicide?” |
| Price & Karim, 1975 [40] | Fiji (1971-1972) | Suicide | N=90 suicides | Case series | Surveillance of death certificates and post mortem records of the Fiji Medical Statistics Department and the perusal of mental hospital case sheets. Additional data were collected by detailed survey of the circumstances of suicides in two defined localities in Fiji by interviewing next of kin. |
| Pridmore et al., 1995 [42] | Fiji (1969-79, 1980-89) | Suicide & SA | Population of respective country | Ecological study | Monitoring of annual reports of the Ministry of Health (and equivalent authorities), which is based on individual hospital reports. |
| Pridmore et al., 1996 [41] | Fiji (1st July 1985-30th June 1993) - eight years | Suicide | N=304 suicides (hanging or poisoning) | Case series | Autopsies held at two hospitals. Cases were accepted where all details of residence, race, sex and age were given and where the pathologist found that poisoning or hanging had caused death. |
| Pridmore, 1997 [52] | Solomon Islands (Jan 1989-Jul 1993) | Suicide & SA | N=13 suicides N=123 further instances of suicidal behaviours |
Case series | Surveillance from the "suicide book" maintained by the Casualty Department of Central Hospital (the date, name, sex, method of self-injury, and, in the case of ingestion, the name and amount of drugs consumed). |
| Ran et al., 2015 [48] | Guam (2009) | SA | N=207 (response rate 82.1%) | Cross-sectional study | Self-report survey of students at the University of Guam (all students were invited to participate) where young people were asked about lifetime suicide attempts |
| Ree, 1971 [43] | Macuata province in Fiji (1962-1968) | Suicide | N=73 suicides | Case series | Surveillance from police records in Macuata Province. |
| Roberts et al., 2007 [44] | Fiji, Western Viti Levu (January 2004-December 2005) | SA | N=132 suicide attempts | Case series | People referred to Family Support and Education Group after attempted suicide |
| Rubinstein, 1983 [51] | Micronesia (widely) (more specifically covered Federated State of Micronesia (Yap, Truk, Ponape), Republic of Palau and the Marshall Islands (Kwajalein and Majuro)) 1960-1980 | Suicide | A case file of “over 300” suicides (as well as “over 300 suicide attempts” although analyses did not investigate these further) | Case series | All available official reports were examined for data relevant to Micronesian suicides during the post-war period. These sources included hospital and medical records, all death certificates from each District Clerk of Courts Office, police records and statistics where compiled and pertinent church records. Supplemented with 250 psychological autopsy interviews. |
| Sakamoto et al., 2020 [54] | Commonwealth of the Northern Marianas Islands (2017) | SA | N=1943 (response rate of 64%) | Cross-sectional study | Youth Risk Behavior Survey for the CNMI. Survey used two-stage cluster sampling strategy and was for grades 9-12, where students were asked “During the past 12 months, how many times did you actually attempt suicide?” |
| Sharma et al., 2017 [57] | Kiribati, Solomon Islands, Vanuatu (2011) | SA | N=1582 (Kiribati); N=1421 (Solomon Islands); N=1119 (Vanuatu) Response rate varied from 72% (Vanuatu) to 85% (Kiribati & Solomon Islands) |
Cross-sectional study | Secondary analysis of the GSHS (see above). |
| Tavite & Tavite, 2009 [53] | Tokelau (1980-2004) | Suicide & SA | N=142 completed a cross-sectional survey (aged 15-45); N=6 suicides; N=40 suicide attempts | Case series | Surveillance of all available records on suicidal cases (1980-2004), interviews with relatives of those who died by suicide, or those who attempted suicide (1998-2004); cross-sectional study of all people in Tokelau in 2004. |
| Vignier et al., 2011 [50] | New Caledonia (2007) | SA | N=1400 youth aged 16 to 25 years (response rate 88.1%) | Cross-sectional study | A survey of young people using a stratified sample based on 2004 census data were constructed for each of the four geographic regions; the stratifying factors were sex, age group, and school enrolment status. Young people were asked “Have you ever tried to commit suicide?” |
| Wainiqolo et al., 2012 [45] | Fiji; Viti Levu (1st October 2005 – 30th September 2006) | Suicide & SA | N=78 suicides; N=144 suicide attempts | Case series | Surveillance of all injury-related deaths and primary admissions to hospitals using the Fiji Injury Surveillance in Hospital database (used an adapted version of the WHO Injury Surveillance Guideline). TRIP-10 |
Note: TAU = treatment as usual; BIC = brief intervention contact; NFSB = non-fatal suicidal behaviour; SA = suicide attempt; WHO = World Health Organization; CNMI = Commonwealth of Northern Marianas Islands; GSHS = Global School Based Health Survey; TRIP = Traffic-Related Injury in the Pacific Project.