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Therefore, we assessed how informative a postcode-based data linkage approach is to study the association between contextual factors and depressive symptoms in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, we linked individual-level survey data from a multi-setting clinical sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092,323) with population-level routine data from two different German datasets to assess depression severity. Contextual data included area-level deprivation, civic participation, population structure and the built environment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Including contextual factors in the models increased their model fit (AICc Model 2\u2009=\u200913,640.80) compared to the demographic factors-only model (AICc Model 1\u2009=\u200913,718.24; \u0394 AICc\u2009=\u200977.18). Assessing each contextual factor alone revealed that area-level deprivation yielded the most parsimonious fit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The data linkage approach is a technically viable and resource-friendly approach within the German mental health research infrastructure. In this multi-setting clinical sample, incorporating objective contextual variables improved the models. However, choosing the appropriate spatial resolution is essential, as coarse aggregation may obscure meaningful contextual associations with depression severity. To ensure the linkage is meaningful, administrative indicators must be carefully chosen based on existing literature to guarantee they are proxies of environmental factors that are associated with mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00406-026-02335-6","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:38:26Z","timestamp":1790779106000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between community contextual factors and depressive symptoms: postcode-based data linkage of POKAL survey data with publicly available German routine data"],"prefix":"10.1007","author":[{"given":"P.","family":"Schoenweger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Sachse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Brisnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"B\u00fchner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ditzen-Janotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Dreischulte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Eder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Falkai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Gensichen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"G\u00f6kce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Henningsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Junker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Krcmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Lukaschek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Pfeiffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Pitschel-Walz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Schillok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Teusen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"von Schrottenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Jung-Sievers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2335_CR1","unstructured":"World Health Organization Comprehensive Mental Health Action Plan 2013\u20132030 [Internet]. 2013 [cited 2022 Feb 8]. 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PF received research support\/honoraria for lectures or advisory activities from Boehringer-Ingelheim, Janssen, Lundbeck, Otsuka, Recordati, Richter and BMS. The research reported in this publication was funded by the German Research Foundation (DFG-GrK 2621\/POKAL-Kolleg). The study was endorsed by the Ministry of Research, Technology and Space (BMFTR) (Bundesministerium f\u00fcr Forschung, Technologie und Raumfahrt) within the set-up phase of the German Center for Mental Health (DZPG) (grant: 01EE2503A, 01EE2503F to PF).","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All five POKAL substudies involved human participants and received approval from the respective Medical Ethics Committees of the LMU Munich Medical Faculty and the Technical University of Munich\/University Hospital Klinikum rechts der Isar with the following project numbers: 22\u20130637 169\/21 S-EB [\n                      \n                      ], 2022\u2013158\u00a0S [\n                      \n                      ], 63\/22 S-KK [\n                      \n                      ], 22\u20130028 [\n                      \n                      ], 2022\u2009\u2212\u2009507_1-S-KH [\n                      \n                      ]. Informed consent was obtained from all participants prior to enrolment.","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No details, imaged or videos relating to individuals were published in the manuscript.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}