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We examined the associations of violence, patient dissatisfaction and occurrence of rapid tranquillisation in psychiatric intensive care, using an on-line nursebased computerised database over a two-year period. Non-Caucasians were over-represented in violent incidents with physical threat, and previous forensic history was associated with more violent means of attack. Dissatisfaction related to non-understandable provocation and the total number of violent incidents. There was no correlation between rapid tranquillisations or side-effects and dissatisfaction. Remedial action and education in the psychiatric intensive care unit may reduce violence, and better prescribing habits, avoiding anti-psychotic polypharmacy in rapid tranquillisation, should be encouraged.The aims of the present study were to audit the usage of a psychiatric intensive care unit and the occurrence of violent incidents over a two-year period, and to measure patient dissatisfaction with the service and correlate it with violent incidents, rapid tranquillisation episodes and total side-effects. The studyThe psychiatric intensive care unit in South Manchester, established in 1992, has 12 beds and serves a population of 175 000 (aged 16-65) with 80 other general adult beds on a district general hospital site. Black and ethnic minorities make up 11% of the catchment population. To identify and measure violent incidents a nurse-run interactive computer system was established, the Psychiatric Studies in Aggress ion Database. Daily ratings were made for the first seven days, then weekly, on symptom, general aggression and side-effect rating scales. Specific violent incidents are recorded using the Staff Observation of Aggression Scale (SOAS)of Palmstierna & Wistedt (1987). A patient/user dissatisfaction questionnaire was included for use on discharge or transfer back to the base ward. It had three groups of scores on dissatis faction with the ward environment, information made available to people on admission and nurse/doctor contacts.Rapid tranquillisation events were also re corded through the SOAS and patients' sideeffects during their stay were rated on a simple seven-item three-point rating scale. Items com prised tremor, rigidity, dystonic reaction, akathisia, visual difficulties, tardive dyskinesia and 'other' ratings. All side-effect ratings were to talled over the duration of stay. Rapid tranquil lisation was mainly by intramuscular zuclopenthixol acetate or haloperidol, often with the addition of lorazepam intramuscularly. The medication used was down to individual con sultant team choice with no overall unit policy at this time. Doses used generally followed British National Formulary guidelines, although higher doses were occasionally used in very disturbed or resistant cases.

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