Deathsmiles counts as a horror game, right? Surely it does. In which case:
Deathsmiles (97% positive on Steam) is easily my #1 recommendation out of all horror games on PC, no question (just so long as you can tolerate the game's pandering to
a certain audience). It's got finely-crafted bullet patterns as fearful as the monsters spewing them, along with much higher production values than your average shoot-em-up. And it seems to be a tad more accessible than the average Cave shmup, difficulty-wise (but there's still plenty there for those who want to seek out more of that). Alas, at the moment, this recommendation is aimed more at GOG's curators than at GOG's customers. :/
(Outside of PC, though, I love
Guwange even more. That one's easily one of my favorite arcade games of all time. If you don't mind a challenge, please check it out if you can.)
Honorable mention goes to Akiragoya's/Artesneit's games, which tend to include wonderfully creepy Giger-esque body horror that's right up my alley.
(That said, I've gotta say, I'm really looking forward to playing each of these:
A Plague Tale: Innocence Agony CARRION Darkwood Detention Devotion DreadOut (like a poor man's Fatal Frame?)
Hellblade: Senua's Sacrifice Observer: System Redux Succubus WORLD OF HORROR,
and I would love the opportunity to try:
Alien: Isolation DreadOut: Keepers of The Dark DreadOut 2 FATAL FRAME / PROJECT ZERO: Maiden of Black Water (kinda like Shoot the Bullet in first-person?; well, maybe not exactly),
but of course I can't recommend these with full confidence without having actually played them just yet, even if they do look quite promising from most of what I've gathered.)