Ok. This is definitely the scariest game I have ever played. EVER. You will jump countless times during the duration of this game. The enemies you encounter in this game are completely psycho, and they will scare the crap out of you time and time again.
The game isn't perfect, though. While the environments are nicely done, the character models are shiny and rubbery. They look sort of like bendable action figures. This doesn't stop the game from being scary, it's just a little disappointing considering how wonderfully decrepit the environments are.
The controls feel great--walking, moving and attacking couldn't be easier. But it is repetetive. The game works fine, it just needs more to do--smacking insane people with various objects the same way over and over just isn't enough. But god, does it ever feel satisfactory to dig a fire axe into the skull of a madman. And, what's even cooler is that, once you've gotten an enemy down on their knees you can do a special kill--snapping their neck, headbutting them, etc. The game is rated M, by the way.
Unfortunately, the guns aren't much fun to use, which is why I tended to stay away from them throughout most of the game--it's just takes more skill and strategy to use melee attacks. And don't think that I felt the game was repetetive because I played it this way--the guns that are there are few and far between anyway.
All in all, this is a frightening and intense game. It will creep up and burrow its way into your dreams and stay there for a good while. That's freaking awesome, because I have never, never ever had a game do that before. Playing this game at 12:00-1:00 at night with all the lights off is scarier than watching most horror movies these days.
The repetition can grate on your nerves after a while, but this game accomplishes what it set out to do: scare the crap out of people, and more importantly, establish itself as a heavy-hitter in the horror genre. This is by far the scariest game I have ever played, and I can't wait to see what Monolith does with the sequel.