4.48 Psychosis is the final play by British playwright Sarah Kane. It was her last work, first staged at the Royal Court's Jerwood Theatre Upstairs on 23 June 2000, directed by James Macdonald, nearly one and a half years after Kane's death on 20 February 1999. The play has no explicit characters or stage directions. Stage productions of the play vary greatly, therefore, with between one and several actors in performance; the original production featured three actors. According to Kane's friend and fellow-playwright David Greig, the title of the play derives from the time, 4:48 a.m., when Kane, in her depressed state, often woke. Subject The play is usually interpreted as an expression of the experience of clinical depression, a disorder from which Kane suffered. She died by suicide after writing the play, before its initial performance. Contemplation and discussion of suicide are prominent and while there is no strict narrative or timeline, certain issues and events are clearly dealt with: deciding whether to take medication to treat depression, the desires of the depressed mind, the effects and effectiveness of medication, self-harm, suicide and the possible causes of depression. Other themes that run throughout the script, in addition to depression, are those of isolation, dependency, relationships, and love. Form 4.48 Psychosis is composed of twenty-four sections which have no specified setting, characters or stage directions. Its language varies between dialogues, confessions and contemplative poetic monologues reminiscent of schizophasia. Certain images are repeated within the script, particularly that of "hatch opens, stark light"; a repeated motif in the play is "serial sevens" which involves counting down from one hundred by sevens, a bedside test often used by psychiatrists to test for loss of concentration or memory. Productions Owing to its form, productions of the play differ vastly in their staging, casting and design. Aside from the initial production of 4.48 Psychosis at the Royal Court in 2000, there have been performances of 4.48 Psychosis at The Theatre Les Bouffes Du Nord in Paris (2005), Belarus Free Theatre in Minsk (2005), KUFER theatre in Croatia (2005.), Old Red Lion Theatre (Tangram Theatre, 2006), Arcola Theatre (2006), the Young Vic Theatre (2009), the Barbican Theatre (TR Warszawa, Easter 2010), Access Theatre (Raw Theatre Group, Easter 2010), The Theatre Project (Off Off-Broadway - The Red Room, Summer 2010), ADC Theatre (October 2010), York Theatre Royal (March 2011), Sittingbourne Community College Theatre Company (July 2011),