Objectives. To compare measures of physical self-perceptions and self-esteem of adult psychiatric patients suffering from mood disorders with norms of non-patients and to investigate the comparative influence of physical self-perceptions and self-esteem on indices of negative affect in these patients.Method. Cross-sectional. Adult psychiatric patients (53 males, 124 females), all with DSM-IV diagnosis of mood disorder and with elevated depression scores, completed the Physical Self-Perception Profile subscales assessing perceived sports competence and condition, body attractiveness, physical strength, and a domain scale of physical self-worth. Also assessed were global self-esteem, using the Rosenberg Self-Esteem Inventory, depression, with the Beck Depression Inventory, and anxiety with the State-Trait Anxiety Inventory.Results. Depressed patients scored significantly lower on physical self-perceptions and global self-esteem than non-patients, consistent with the symptomatology of depression and anxiety. Partial correlation analysis and path analysis indicated that physical self-perceptions explained a significant proportion of variance in negative affects (R 2 from 0.37 to 0.49). With the exception of trait anxiety in male patients, direct pathways became non-significant when global self-esteem was added to the model. Model fit parameters using structural equation modelling indicated the superior fit of the indirect model with global self-esteem as a mediator.Conclusion. The relationship between physical self-perceptions and negative affect is mainly indirect and mediated by global self-esteem in mood disordered psychiatric patients. The Expanded Exercise and Self-Esteem Model, which includes physical self-perceptions and self-esteem estimates, might be considered as a valuable framework for furthering our understanding of the depression and anxiety reducing potential of exercise and physical activity in clinically depressed individuals.