The 2020s’ Weirdest Horror Game Is Becoming A Movie

2026 has been a benchmark year for the intersection of video games and film, with the horror genre in particular benefiting from that cross-medium tether. September gave us Zach Cregger’s Resident Evil, a video game adaptation that quickly became the highest-grossing film in franchise history, rejuvenating the brand’s cinematic potential and stoking fresh interest in the game series. Then, just a few weeks ago, Hellraiser: Revival resurrected a dormant piece of horror movie royalty and proved that modern licensed games don’t have to live in the shadow of Dead by Daylight.

Hollywood’s never met a trend it couldn’t double down on; there’s already a new Silent Hill film in the works, while studios are cooking up a variety of projects ranging from a Dead by Daylight adaptation to films based on Phasmophobia and Amanda the Adventurer. And while all of those are exciting, what’s most interesting is an adaptation of a game that’s become one of the decade’s most hotly discussed indie titles.

On October 29, The Hollywood Reporter announced that Sony Pictures Entertainment is developing a film based on Mouthwashing, the 2024 indie darling from developer Wrong Organ and publisher Critical Reflex. Scott Derrickson and frequent co-writer C. Robert Cargill are producing the film under their production company, Crooked Highway, where they co-produced both Black Phone movies. Matt Manfredi and Phil Hay will write the screenplay, and Karyn Kusama will direct; the three previously collaborated on 2015’s The Invitation and 2018’s Destroyer.

Mouthwashing is a slow descent into a guilt-ridden psychological nightmare, comparable to sci-fi films like Event Horizon, Sunshine, and Alien. While the light gameplay is mostly a vehicle for an interactive movie with minor puzzle-solving elements, the real centerpiece is the narrative. The game follows the crew of the Tulpar, a stranded freighter spaceship. As the weeks turn into months and the five survivors slowly lose their hope and their sanity, you, as co-captain Jimmy, uncover your own complicity in a disturbing tragedy that may have led to the ship’s ruin.

Although there have already been a few horror game adaptations in the last few years (and more coming), Mouthwashing’s emphasis on dread and paranoia, and its surreal, horrific, nonlinear gameplay experience helped it stand apart from traditional survival horror fare — indeed, the game won numerous awards in 2024. Those same attributes may help it succeed as a distinct adaptation.

Karyn Kusama certainly feels like a perfect director: she’s no stranger to horror, having directed Jennifer’s Body in 2009, as well as an episode of HBO’s Stephen King adaptation The Outsider. Her current work on Amazon Prime’s Life is Strange adaptation means she already knows something about gaming, while The Invitation proves she can use escalating tension and an unreliable narrator to nail-biting effect. Mouthwashing has already taken gaming by storm with its deeply unsettling tale of sin and madness in outer space, and with so much talent attached, it may only be a matter of time before it does the same on the big screen.