Catherine is rated M (Mature 17+). Its content descriptors are: Blood, Partial Nudity, Sexual Themes, Strong Language, Use of Alcohol, Violence.
You can read the full rating summary from the Entertainment Software Rating Board below:
This is a puzzle adventure game in which players assume the role of Vincent, a man with relationship issues that are manifested in his dreams. The game transitions between animated cutscenes and puzzle stages (i.e., nightmares); in the nightmare world, players must help Vincent ascend crumbling towers by pushing, pulling, and climbing blocks to reach an exit. If players make the wrong move, they can be killed by spike traps and giant boss creatures (e.g., a demon bride, a chainsaw-wielding baby); death scenes are accompanied by exaggerated splashes of blood as Vincent is stabbed, crushed, shot, or bitten. During one cutscene, a character is stabbed in the stomach with a knife; a large pool of blood quickly forms under her body. In order to move faster in the puzzles stages, players can order Vincent alcoholic beverages (e.g., mixed cocktails, beer, sake, whiskey); after three drinks, he begins to stumble around when moving. These sequences are accompanied by voice-over narration: “It’s said that chugging alcohol isn’t good for you, but sometimes it’s necessary” and “[T]ake a big swig of cognac!” Throughout the game, sex and sexuality are frequently referenced, sometimes while two characters are in bed together (e.g., “I finally became a man! Got rid of my V-card, BOOM,” “If the one you loved confessed to a sexual habit that you found absolutely unacceptable, what would you do?” and “After all you’ve done to my body . . . Night after night . . .”). One bedroom sequence pans across a man’s legs, then to his curling toes; another scene briefly depicts a woman caressing her body while making suggestive comments (e.g., “I’ve got such a hunger for these feelings . . . I know you have some hungers as well, don’t you?” ). The game also depicts the central character surrounded by topless female demons—though shadow effects obscure most details. The words “f**k” and “sh*t” can be heard in the dialogue.
Catherine first released in Japan in February 2011 for PlayStation 3 and Xbox 360. It released in North America in July 2011 and Europe in February 2012. Its updated version Catherine: Full Body releases for PS4 and PS Vita in Japan on February 14, 2019 and worldwide in 2019.