Fans of Myst and Oblivion will most likely enjoy this game. It's immersive, dark, and dreary. The gameplay is heavy on puzzles, character dialogue is well developed, but running is neither necessary nor an option. As far as I got, it would work just as well as a point-and-click.
If you like to look around as opposed to tearing through the game at hyper speed, this title is NOT for you. Every disturbing image--and there are plenty--costs you insanity points. What this does is make the screen pulse, especially when you are looking at enemies. By Chapter 3 this made the game unplayable for me personally. I've never got sick to my stomach from a game before, and sadly it was not for a good reason.
Another thing that the insanity score will do is slow down your character's movement speed. Yes, it's a great thing to experience the first few times it happens, but after that it makes the game extremely tedious.
I'm currently rating this title a 7/10 for the initial story, ambiance, level of immersion and the novel approach to interacting with the game world. There is no HUD, so very little is left to remind you of the separation between you and the crazy world which you just entered.
Unfortunately, some of the puzzles feel too contrived to be enjoyable...and this breaks the flow of the game. When it comes down to stepping on exactly the right pixel at the right time, the game ceases to be fun.
If you like shoot-'em-up atmospheric horror, check out The Suffering.
I will be watching a playthrough of this game, and when I'm done I will update my review.