The study aimed to compare potential differences in trajectory of depressive symptoms improvement between patients receiving attribution retraining group therapy (ARGT) and those undergoing first-line depression medication in clinical care. Participants were randomly assigned to ARGT (n = 63) and medication (n = 66) group. Patients in ARGT group received group therapy one session a week for 8 weeks, while patients in medication group took medication normally. Hamilton Depression Scale was

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... ed for all participants at 5 sequential time points during the process. A mixed-effects linear model over 5 time points showed no significant differences between two treatments in the total depression scores. Both medication and ARGT had effectively reduced depressive symptoms. However, the pattern of symptoms improvement differed. In detail, ARGT preferentially targeted cognitive disturbance, retardation and hopelessness, while medication preferentially targeted factors related to diurnal variation, moreover, for ARGT, the pattern was weight and diurnal variation (week 2), sleep disturbance (week 4), anxiety, cognition disturbance, retardation and hopelessness (week 6), for medication, was sleep disturbance, anxiety, weight, and diurnal variation (week 2) cognition disturbance, retardation, hopelessness (week 8). The current finding showed ARGT reduced the depressive symptom and improved well-being in a different way, which may further benefit the advancement of precise treatment.