In 1978, the novel was adapted into the film Despair, directed by the German filmmaker Rainer Werner Fassbinder and starring Dirk Bogarde. The film's screenplay was adapted by Tom Stoppard. In 2015, the novel was adapted into the light novel Danganronpa Togami, written by Yuya Sato and focusing on Byakuya Togami as they encounter their own apparent doppelgängers in Prague.
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