Solid, spooky, epic game with some of the most ingenious (and diabolical) surprises.
There are, however, two elements that make this game stand out from the generic clones of the genre. First, this game outright scared me several times. The out-of-nowhere, ghostly image of the girl hanging in the bathroom caused me to jump out of my chair. There were several other such instances. These high-impact fright moments are done better in this game than in any other I've played (admittedly, I'm not a huge fan of the horror genre). Second, the game developers ingeniously incorporated outside-the-gameplay elements into the gameplay.
What does that mean? Well kinda hard to explain, but it leads to perhaps my personally most embarrasing gaming moment ever. In the game your character has a sanity meter. The more damage the character takes or the longer she's exposed to certain enemies the less sanity she possesses. If your sanity completely drains away you start experiencing...well, insanity.
How does this manifest itself? Generally in standard gameplay elements like lost focus, inability to manipulate weapons or spells, that kinda stuff. However, just for funsies, the developers also included a diabolical element where your gamesave screen didn't function properly. For me, the first time this occured was 95% through the game. Shortly after surviving a tough encounter, with sanity basically gone, I saved the game. At least I thought I did...however, after pressing "save" the game responded with "Gamesave successfully deleted" and then returned me to the main screen.
Arggggh! I basically went nuts. In fact, I stopped playing the game completely for several months. It wasn't till I ran across something on Gamespot that noted this was a ruse set up by the developers. I went back and found my gamesave was still there...and was able to finish the game. The developers essentially pulled one over on me. This is perhaps the most innovative, and diabolical, game effect I've experienced. Combine this with all the other solid horror elements and you have a top-5 GC game AND a top-5 all-time horror game.