Psychological mood or distress in patients with systemic sclerosis (SSc) is only weakly related to physician-assessed disease severity, self-reported symptoms and physical functioning. Psychological variables such as social support indices, disease-related cognitions and coping strategies are likely predictors of depressed mood. Until now, however, the independent association between these variables and psychological mood in patients with SSc after controlling for disease severity, symptoms and functioning has not been studied. One hundred and twenty-three patients completed questionnaires measuring symptoms, physical functioning, social support, cognitions, coping and depressed mood. Depressed mood was measured using a subscale of a self-report function scale developed for patients with rheumatic conditions. In addition, disease severity was assessed by a rheumatologist. In the final analysis, being married, higher levels of perceived potential support and higher levels of disease-related cognition acceptance each showed independent associations with lower levels of depressed mood after controlling for disease severity, self-reported symptoms and function. Expression of emotion showed associations with higher levels of depressed mood. These findings suggest that psychological interventions in SSc should try to improve social support skills and acceptance of the disease by the patient.