According to the ESRB, this game contains: Blood, Partial Nudity, Sexual Themes, Strong Language, Use of Drugs and Alcohol, Violence
Parents will want to be aware that this game is the total package—it has it all. There is strong language, there are graphic killings, characters drink wine and champagne, there are some quasi-occult overtones, an unexpected female shower scene and one instance of two characters obviously having intimate relations. Without a doubt, this game should be reserved for only the most mature players, and under no circumstance should any small children play this. Please don't be mistaken in thinking that this game uses these elements for sensationalism or to cheap effect—it doesn't. But, similar to the way that an R-rated film can contain completely appropriate subject matter for the right audience, the fact is this is an adult game for adults.
Players looking for something completely different need to check this out. It's a mature, sophisticated, and well-told story couched within a structure and framework that is as close to being something new under the sun as we get these days. The influences are obvious to see, but the elements come together create something that is well worth notice and examination—maybe even a little bit of celebration.
Deaf and Hard of Hearing gamers are in good shape. There are no significant auditory cues during gameplay, and all voiceovers are delivered accompanied by full text. Occasionally there is some confusion as to who is talking since the subtitles are not color-coded, but these instances are few and far between. Buy and play this with confidence.