PLOT SPOILER WARNING... I was under the distinct impression that they wanted to harm me and their appearance alone made me feel like I had to defend myself? To be honest, their appearance made me thing they were just regular people trying to go about their day and I was hallucinating. I only felt like I had to defend myself because they killed the fuck out of me if I didn't.
Feedback on a 10 year old game probably isn't going to be helpful to the designer, but I think the twist would have worked better if the NPCs didn't kill you on sight for no reason the second you see them. I get that the quick deaths provide a sense of danger, but you could still get that without having the NPCs start out as hostile. It would have worked better if the NPCs looked threatening, but didn't start attacking you until you attacked one of them and progression quickly required you to kill at least one NPC soon after the game started. If you start killing people in an area, it makes sense for people to come after you. It also makes sense for some people not to because they aren't yet aware of what's going on. If the player doesn't know which threatening NPCs are going to hurt them, which are just going to look threatening, and which ones are going to go after them now when they didn't before, they still get the fear and they're probably just going to start killing all of NPCs on sight anyway. I think that would have made a little more sense than having the character say he just felt threatened in a game where NPCs are killing you before you even realize you have a means of harming them.
It was a very good game. I enjoined it and appreciate the work that was obviously put into it. I just wanted to throw out that criticism on the off chance that it might benefit someone making a similar game and because that dialog at the end cracked me up. It really lightened the mood after playing a pretty suspenseful game.