there is a paucity of research which has assessed this association. In particular, there is little data from prospective population-based studies, which reduce potential biases related to temporal association and sample selection. In an inpatient sample, Holahan and colleagues28 found that drinking to cope among depressed patients was associated with an increase probability for consumption of alcohol and development of alcohol problems during a 10-year follow-up period. Yet, studies in clinical settings may not provide an adequate assessment of self-medication for mood symptoms with alcohol dependence. Although a high proportion of individuals with mood and alcohol disorders are seen in clinical settings, many if not most of the individuals affected with these conditions fail to be identified and never receive treatment.29;30 Prior estimates indicate that only approximately 42.1 to 60.9% of those with an affective disorder20 receive treatment for their mood symptoms. A much lower proportion of individuals with an alcohol use disorder ever receive clinical attention, and some estimate that only 4.8% to 27.9% of those with alcohol abuse or dependence receive treatment.29
