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Introduction Systemic sclerosis (SSc) is a chronic, systemic, autoimmune disease with highly heterogeneous clinical manifestations. The disease causes functional disability and psychological disorders, especially anxiety and depression.Comprehensive management of patients with SSc should include clinical, functional, and emotional assessment, but the latter are difficult to address because their evaluation can be highly subjective. Therefore, the use of PROs in the clinic can be useful for identifying and assessing potential functional and/or psychological disorders.The objective of this study is to identify, through the use of PROs, functional disability and depressive symptoms in patients with SSc and to analyze their relationship with the systemic burden of the disease.Material and Methods Cross-sectional observational study in patients with SSc (2013 ACR/EULAR criteria). Clinical and demographic data were collected from electronic medical records; patients completed the following questionnaires during the visit: the Health Assessment Questionnaire (HAQ) to measure functional disability, the Systemic Sclerosis Symptom Questionnaire (SySQ) to assess the systemic burden of SSc, and the PHQ-9 and Beck Depression Inventory (BDI) to assess anxiety and depression.Results Thirty-nine patients (84.61% women) were recruited, with a mean (SD) age of 57.9 (11.4) years and a mean SSc onset of 9.5 (6.9) years.The reported systemic burden was mild in 28.2%, moderate in 25.6%, and severe in 46.15%. Perceived functional disability was moderate/severe in 30.86% of patients.Regarding psychological disorders, moderate/severe perceptions of depression and anxiety were observed in 38.47% (PHQ9) and 21.52% (BDI), with a high correlation between the two measurements (r=0.82).A statistically significant association was observed between the perception of depression and anxiety and greater functional disability (PHQ9 P<0.001; BDI P<0.001) as well as greater systemic burden (PHQ9 P=0.009), regardless of the patients’ age, sex, and duration of illness.The results of the psychological distress questionnaires were not associated with the patients’ age or sex. The PHQ9 did appear to increase with increasing duration of illness (P=0.045).Conclusions In patients with systemic sclerosis, there is a close relationship between the degree of functional disability, systemic symptom burden, and the presence of depressive symptoms.It is important to perform a multidimensional assessment using validated questionnaires that allow us to identify patients at greater psychosocial risk, facilitating early, multidisciplinary intervention.The PHQ-9 is an efficient and sensitive tool for assessing the emotional impact of the disease in these patients.