As cut-throat as cut-throat can get, but at least you go into it expecting that.
I love the strategy involved in this game. When I lost - and lost hard - the first two times, I was upset but felt like I knew how to be better. And sure enough, I took what I learned into the third game and won gloriously.
Big props for making the Chaos Gods so different.
The faults: not nearly as good with three players, and way too long with five (assuming you have the Horned Rat Expansion). The Chaos cards also need to be more diverse.