Through its final twist, Madhouse examines how past trauma can fracture a personality, leading to a literal and figurative "house divided".

The basement is characterized by dark, gritty visuals and "stomach-turning" practical effects, creating a sense of claustrophobia and impending doom.

The narrative’s tension is anchored by the physical hierarchy of the facility. While the upper floors house "garden variety" patients, the basement—uniquely dubbed "The Madhouse"—is a hellish environment for the most dangerous and forgotten inmates.

Reviewers highlight the "Argento-esque" nature of the kills, particularly a cringeworthy electrocution scene that remains a standout for practical effects fans.

The film employs "herky-jerky" ghostly figures and frantic editing, a style popular following the success of The Ring (2002).

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