Panic disorder (PD) is a severe and chronic psychiatric disorder, with genetic components underlying in its etiology. The PERIOD2 (Per2) gene has been reported to be associated with familial advanced sleep phase syndrome. Considering the high frequency of sleep disturbance in PD, Per2 may be a candidate gene for PD. Therefore, we conducted a two-stage case-control association study in the Japanese population. In the first screening sample of 203 patients and 409 controls, we investigated three single-nucleotide polymorphisms in Per2. We found a potential association in the screening sample (rs2304672, genotype P¼0.046, uncorrected), whereas we could not replicate the association in the second sample of 460 patients and 460 controls. Our results suggest that Per2 may not have a major role in the pathogenesis of PD in the Japanese population. Keywords: case-control study; Japanese population; panic disorder; Per2Panic disorder (PD) is an anxiety disorder characterized by panic attacks and anticipatory anxiety, with a lifetime prevalence of 1-3% and a female:male ratio of 2:1. 1 PD frequently takes a chronic course, with many remissions and relapses, occasionally complicated by comorbidity with other psychiatric disorders, such as agoraphobia and major depression. 2 Twin and family studies have provided evidence for both genetic and environmental factors, contributing to susceptibility to PD. 3,4 Heritability of PD has been estimated about 40% on the basis of the meta-analyses of twin studies. 5 Because of the phenotypic and genetic heterogeneity of PD and the small effect size of individual variants, only a few candidate genes have been identified so far. 6 Sleep disturbance is frequently present among psychiatric patients and has been incorporated in the diagnostic criteria for major depression, post-traumatic stress disorder and generalized anxiety disorder. Several studies demonstrated that individuals with PD report significant sleep disturbances. 7,8 The sleep-wake cycle, as well as other rhythmic variations in physiological and metabolic processes (hormone production, feeding behavior and brain activity), is generated by an endogenous pacemaker. In mammals, the principal circadian clock, which coordinates peripheral clocks in the body, is located in the suprachiasmatic nucleus and produces a nearly 24-h cycle through interacting positive/negative feedback loops. It is comprised of the positive regulators (CLOCK/ARNTL complexes) and the negative regulators (PER1, PER2, PER3, CRY1 and CRY2). 9 A polymorphism of PERIOD2 (Per2) has been reported to be associated with familial advanced sleep phase syndrome. 10 Carpen et al. 11 founded that the 111G allele of Per2 (rs2304672) was associated with extreme morning preference. Lee et al. 12 reported that the G3853A single-nucleotide polymorphism (SNP) of Per2 (rs934945) was associated with diurnal preference in Korean subjects. Per2 was nominally associated with bipolar disorder, 13 whereas no associations of Per2 with mood disorders and anxiety disorders have also b...