The article reviews research on the problem of interrelationship between different physical and psychosocial factors in type 1 diabetes mellitus (DM1). The authors consider methodological principles of health-related quality of life (HRQoL) assessment in DM1 patients and stress the need for an integrated biopsychosocial approach to the management of the disease. DM1 is a chronic metabolic disease with an absolute requirement for insulin replacement therapy. The stress-inducing nature of DM1 is associated with its unexpected and dramatic manifestation in juvenile years, life-threatening nature of severe hypo-/hyperglycaemias and long-term complications, with the burden of diabetes self-management, threat of work disability, employment and career problems etc. These features of DM1 increase the likelihood of the development of anxiety and depressive disorders, which, in turn, may negatively influence the course of diabetes and in particular, diabetes self-care. This necessitates early diagnosis of emotional and behavioral disturbances in DM1 using self-report instruments as well as clinical assessment. Evidence suggests that active problem-focused coping behavior and adequate social support promote adherence to diabetes regimes and may act as a buffer against negative effects of the disease on HRQoL in DM1 patients. The core element in the HRQoL structure is personal disease picture (as opposed by objective clinical picture) -the cognitive-affectivebehavioral complex reflecting the patient's personal perception of the disease. Examination of the personal disease picture and attitude towards the ailment in DM1 patients may help to improve understanding of the mechanisms of poor adjustment. Problems in disease adjustment can be detected also by diabetes-specific HRQoL assessment. The measures of HRQoL can be applied as screening instruments useful in increasing the effectiveness of patient-provider interactions and diabetes care. Keywords: diabetes mellitus, psychosocial factors, disease adjustment, health-related quality of life, psychological assessmentEl artículo revisa la investigación del problema de la interrelación entre diferentes factores físicos y psicosociales en la diabetes melitus tipo 1 (DM1). Los autores consideran los principios de la evaluación de la calidad de vida relacionada con la salud (CVRS) en pacientes de DM1 y ponen de manifiesto la necesidad de un abordaje biopsicosocial integrado del manejo de la enfermedad. La DM1 es una enfermedad metabólica crónica con una necesidad absoluta de terapia de reemplazo de insulina. La naturaleza estresante de la DM1 se asocia con su aparición inesperada y dramática durante los años de juventud, la naturaleza peligrosa de las hipo e hiperglucemias y las complicaciones a largo plazo, con la carga del auto-cuidado de la diabetes, la amenaza de discapacidad laboral, problemas de empleo y carrera, etc. Estas características de la DM1 aumentan la probabilidad de desarrollar trastornos de ansiedad y depresivos que, a su vez, pueden afectar negativamente el curso ...

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The paper deals with methodological issues related to the link between the processes of forming the internal picture of the disease and coping behavior in the dynamics of the subjective and objective factors of the psychosocial functioning of the personality. From our point of view, there are significant stages, implying the association of the components of the internal picture of the disease, as well as the personal meaning of health and coping behavior. The variants of their interdependence in the structure of the integral adaptation process are considered, which, in turn, determines the patient’s essential understanding and assessment of the quality of life (QOL) in the actual life situation.