The sound design and often the art direction are incredible, this seems like a great and respectful depiction of schizophrenia and psychosis, but its gameplay is extremely uninteresting and barebones. All of it 'works' but it never gets either interesting or engaging. One puzzle section was impressive from its execution, one fight section was cool (mostly carried by the atmosphere) and one boss had a cool concept. That's where the praise for the gameplay stops.
Barebones repetetive combat, barebones puzzles, and otherwise tortured third person over the shoulder walking. Scattered "audio logs" that tell you some nordic lore to break up the monotony are thrown in aswell.
It just seems sad because not only could this have better gameplay, but something that works more hand in hand with the themes and main aspects.
The boldest thing it does is have limited lives. Which I would find cool, but is completely misplaced in this type of game. Potentially forcing you to replay those long stretches of uninteresting and boring gameplay would probably just push me into giving up and watching the rest of someone else's playthrough. Luckily, this did not happen.

I would wish to be excited for the sequel, but I'm afraid it will be more the same - now with Microsoft budget. But I am also welcome to be wrong here!