The original Suffering saw Torque escaping from his incarceration on Carnate Island when the prison turned into a horror show -thanks to mysterious appearing demons known as Malefactors. It was bloody, but it was savvy with it. Depending on your actions, it concluded with the knowledge that Torque had either murdered his entire family in cold blood, or was framed for the killing by a man called Blackmore, a shadowy gang leader. Blackmore offered Torque a place in his gang, but when he refused, Blackmore made it his duty to tear Torque's family apart by hooking his kid on drugs and getting our anti-hero sent to jail. Ties That Bind relocates the action to Baltimore City, but if anything, the outlook is darker now than it ever was on death row.

Neatly, Ties That Bind reflects the level of nastiness you showed in the previous game. Plug in a completed The Suffering game file and you'll get one of three intro levels to the game, depending on whether you got the Good, Bad or Neutral ending. Don't worry if you never played the original though, as you'll get the Neutral intro, which introduces you to the characters who appear throughout the rest of the game. It also introduces you to Torque's own dark side. This guy is seriously bollixed in the head, and during the game an insanity meter builds as you take damage. When it's maxed, you can unleash his unholy alter-ego - a powerful demonic form that can be used to punch through walls and smash enemies that are invulnerable to bullets. You don't want to overuse it though, as Torque will take a hefty dose of damage if the bar runs out before you've hit Triangle and switched back to normal. It feels fantastic to deal out death, impaling demons with effortless moves, but because you've got to suffer to use it, you won't waste the ability, so it never overshadows your other killing options.

Ties That Bind uses the same third-person and first-person views as the original, easily switchable with a single button press. Gun control is sharp, and though the third-person view camera can swerve a bit too hastily for proper aiming while dodging, if you need better aim you can just flick into first-person perspective. Mind you, by doing that you'll be even closer to the pant-filling horror. Crucially, although you've quit your prison cage, your surroundings (Torque's old neighbourhood, sewer tunnels, dingy alleys) are still tight and cramped. You can never get quite enough distance from what's attacking you to feel comfortable, but the flexibility of the two viewpoints means it's never annoying. Instead, the confinement makes the game a riot of action, as you're constantly funnelled into dangerous situations. But this is no puppy shoot. Torque can only carry two weapons at a time, so you have to pick your arsenal carefully and use it sparingly - and with such violently aggressive enemies, it's all too easy to spuff whole clips into them, even when they're on the ground. Y'know, just to make sure. If all this sounds restricting, that's because it is - but when combined with such agile controls, that's exactly what makes it so consistently thrilling.

As with the last game, the choices you make in Ties That Bind determine your morality. And there are plenty of set-piece moments to test your resolve. Seconds into the intro level and you're ordered by Blackmore's buddies to murder a prison guard or face a knifing. Later, you have the chance to interrupt a mugging or just watch as the two thugs stab their victim.

At one point we were stuck in a room full of continuously wailing drug addicts and had to give the controller to a friend and ask him to kill them all because we just couldn't face doing it. That the game never tells you what you should do is brilliant - that it can even make you feel guilty about it is better still.

But by far the best thing about The Suffering is its atmosphere, which it has in grave-digging, blood-caked spades. Phantom dogs sprint past your legs and evaporate when out of sight, ghastly images dart unannounced across the screen and gruesome figures cackle at you from the darkness. There's no certainty that what you're seeing is real of if you're hallucinating. Enemies appear and attack, only to vanish - you wait, shocked, gun in hand, but they never come back. Then, abruptly, the rules change. Pounding along one alley we were confronted by a particularly nasty demon, but couldn't get a clear shot before it disappeared into the ground. When it burst out again we just didn't expect it, and even worse, there were actually two of the buggers - we'd never met more than one of them so we fled at high speed, our pulse in orbit.

The Suffering: Ties That Bind is unashamedly adult, but it's not dumb. It doesn't waste time bogging you down with puzzles, it simply slams you with images, action and threats. Just when you think you're running the show, something new and ever more horrific will rise from beneath your feet. Admittedly, this is a game that's heavily scripted, so if you die or replay the game from the start, you'll have a good idea of what to expect and when to expect it. But the action's so incessant and the atmosphere so engaging, that you'll still have your heart beating frantically at the back of your teeth. And a huge, satisfied smile on your face.

Graphics 80%
Beautifully gritty and horrifyingly detailed.

Sound 90%
Disturbing and very well scripted.

Gameplay 70%
Fast, explosive gunplay never gets boring.

Lifespan 70%
Finish it and much of the impact is lost.

Overall 80%
This is not for the faint-hearted, but it is a cleverly shocking and enjoyable demon-blasting game for those who can take it.