Atomoxetine is efficacious in reducing ADHD symptoms. It may have a role in treating comorbid ODD or depression, and probably in comorbid anxiety.

Objective: To investigate the relationships between body mass index (BMI), physical activity and erectile dysfunction (ED). Design and subjects: A population representative cross-sectional analytic study of ED in Hong Kong, with two-stage stratified random sampling, and face-to-face interviews conducted by trained interviewers with structured questionnaires. Study subjects were 1506 men aged 26-70. Results: Age (odds ratio (OR) ¼ 1.30; 95% confidence interval (CI) 1.20-1.40), physical activity (OR ¼ 0.91 per 500 kcal/week; 95% CI 0.84-0.98), and general psychological distress (OR ¼ 1.03 per GHQ score; 95% CI 1.00-1.06) were independently associated with ED after multivariate adjustments. An U-shaped relationship between BMI and ED was observed only among men with no exercise (oonce/week): BMI o18.5 (OR ¼ 2.99; 95% CI 1.01-8.86), 18.5-19.9 (OR ¼ 2.66; 95% CI 1.04-6.79), 20.0-20.9 (OR ¼ 1.37; 95% CI 0.49-3.79), 22.0-22.9 (OR ¼ 1.36; 95% CI 0.58-3.17), 23.0-24.9 (OR ¼ 1.66; 95% CI 0.70-3.93), X25.0 (OR ¼ 2.47; 95% CI 1.08-5.67) using BMI 21.0-21.9 as reference, adjusted for age, GHQ and smoking status. Being physically active (X1000 kcal/week) only reduced the risk of ED (OR ¼ 0.40, 95% CI 0.16-0.95) in men who were obese, adjusted for age, GHQ, smoking status and BMI. Conclusions: BMI and physical activity independently and differentially affected ED risk. BMI had greatest influence with low physical activity, and physical activity exerted greatest influence when BMI was high. This is the first study to demonstrate an U-shaped relationship between BMI and ED risk, but only in men with no exercise, and to identify underweight as a risk factor for ED. This relationship has clinical implications for obese as well as underweight individuals.

Alcohol is long regarded as a risk factor for erectile dysfunction (ED), but epidemiological evidence has been equivocal. We aimed to investigate the ED risk associated with various levels of alcohol consumption by meta-analysis. We searched for population-based studies on ED through Medline, PubMed, PsychInfo, and scanned through reference lists. Eleven cross-sectional studies were included and analyzed with random effects model. We reviewed the results from one crosssectional study and two cohort studies. Regular alcohol consumption was negatively associated with ED (odds ratio (OR) ¼ 0.79; 99% confidence interval (CI), 0.67-0.92; Po0.001). Consumption of 8 or more drinks/week significantly reduced the risk of ED (OR ¼ 0.85; 99% CI, 0.73-0.99; P ¼ 0.007), but consumption of less alcohol (1-7 drinks/week) was not significant (OR ¼ 0.73; 99% CI, 0.44, 1.20; P ¼ 0.101). Begg's test and Egger's test detected no significant publication bias. Our estimates (in sensitivity analyses) were rendered nonsignificant when International Index of Erectile Function definition was used and when statistical adjustment was made only for age. Meta-analysis of crosssectional studies yielded a protective association of alcohol on ED, but the two cohort studies did not demonstrate any significant findings for alcohol consumption. More research is needed to confirm whether alcohol is protective or is unrelated to ED development.