I usually find the Puppet Combo / Torture Star type of PSX horror games pretty boring. This actually has fun gameplay, combined with the overly grotesque visuals and amazing atmosphere those games provide.

It plays alot like silent hill - you are exploring apartments, towns, hospitals, etc trying to find items to progress with minor combat. This game feels like a haunted house, constantly surprising you and pulling the rug out.

I found the gameplay just engaging enough to keep pulling me along the ride, and the hilariously bizarre violence and surreal atmosphere just made an amazing experience for me. I hope to find more games in this style (as opposed to the more walking simulator / stealth survival horror this subgenre is known for).