Client satisfaction is an important variable in evaluating psychiatric services, complementing measurement of other outcomes. An 82-item multidimensional questionnaire (Verona Service Satisfaction Scale) aiming at evaluating satisfaction with community-based psychiatric services was recently developed in Verona, Italy. VSSS-82 contains 29 items translated or adapted from the English-language SSS-30. This study reports the results of factor analysis of the 29 items common to the English- and Italian-language instruments. Factor analyses found four factors accounting for 48% of the common variance for Italian patients. The factor structure is compared with U.S. findings using Harman's coefficient of congruence. A factor called Perceived Outcome/Efficacy satisfaction, based on item content, was well replicated, and there was some equivalence in an Italian factor called Doctor-Patient Transactions and the Practitioner Manner and Skill factor identified in several U.S. studies. Other factors found were called Facility, Policies and Procedures and Appointment/Access. Psychometrics of factor-based subscales and their associations with selected demographic and service variables are presented. All subscales and even more strongly the full 29-item scale were correlated with age. Gender, marital status, employment status, and whether or not the individual was diagnosed as psychotic were not associated significantly with any of the satisfaction measures. Outcome satisfaction was inversely related to a number of service utilization variables, particularly, number of outpatient contacts, days of hospitalization and number of drop-in contacts, all in the prior year. Moreover, satisfaction with outcome was inversely correlated with having had Day-Center contacts. Issues of satisfaction measurement in patients with serious mental illness are discussed.