It's difficult to review this film because I'm left feeling unsatisfied, and contrary to other reviews, it's not because of the ending. Strangely enough, I actually liked the ending.
The storyline is simply and truly strange. I'm never read the source material, so I can't comment on the screenplay's authenticity as an adaptation. The mood of the film, to me, is a combination of perversity, dysfunction, and a weird sense of expressionism. It moves slowly and deliberately, yet it managed to hold my attention until the very end.
The cast does a fine job. Unfortunately, that alone is not enough to motivate me to watch it again. If you're a fan of the eclectic, especially if it's 20th century Japanese cinema, you might find this one worth watching at least once. Otherwise, I wouldn't recommend it.