Linbury theatre, London
Six fearless singers and the Chroma Ensemble, conducted with arresting immediacy by Naomi Woo, rise to the challenge of the brutal musical onslaughts and anarchic orchestrations of Philip Venables’ raw, imaginative score

Sarah Kane revolutionised British theatre with five provocative plays written between 1995 and 1999. Her final work, 4.48 Psychosis, was her most personal, confronting the clinical depression she struggled with for years. The play was first performed posthumously in 2000, after she died by suicide in 1999.

The Royal Opera and Guildhall School of Music and Drama commissioned Philip Venables to adapt the play as an opera, which debuted in 2016. The composer, also known for a certain “in-yer-face” approach, set Kane’s original text almost entirely, realising its 24 disjointed sections in a raw, imaginative score teeming with minimalist licks, prickly synth-pop and consoling nods to the baroque. The libretto shifts between poetic abstraction and scathing exchanges between a patient and a psychologist. An ensemble of six female singers navigates themes of depression, isolation and the agonising choices surrounding medication.

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© Photograph: Tristram Kenton/the Guardian

© Photograph: Tristram Kenton/the Guardian

© Photograph: Tristram Kenton/the Guardian

He tried, however, to remain polite and helpful. As she went about her work, he offered his recollections from his mother's final hours and an account of her long illness, which he had documented minutely over the years. Otto informed the coroner that he was a doctor, but it seemed to him that she was uninterested. She turned to the police officers and, without explanation, told them that this was a matter for law enforcement, before leaving the flat. Otto told me he wondered why nobody was listening to him, the grieving son, the doctor?