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Unusually for a director, Patrice Chéreau, who has died of lung cancer aged 68, had more or less equally prestigious careers in the theatre, cinema and opera. Although he was internationally known from films such as La Reine Margot (1994) and his groundbreaking production of Richard Wagner's Ring cycle at Bayreuth (1976), he was renowned in his native France mostly for his "must-see" stage productions, especially during his long stints as co-director of the Théâtre National Populaire (1971-77) and the Théâtre des Amandiers (1982-90).
At these two subsidised theatres, in Villeurbanne, near Lyons, and Nanterre, in western Paris, respectively, Chéreau was able to introduce modern plays and bring a freshness to bear on the classics, particularly Marivaux, whose La Dispute he directed to acclaim at the TNP in three different versions in the 1970s. At the Amandiers, his sensational 1983 production of Jean Genet's Les Paravents (The Screens) used the auditorium as an extension of the stage.
Chéreau was born in the small town of Lézigné, south-west of Le Mans, in the Loire valley. His parents, both artists, instilled in their youngest son a taste for culture at an early age. When the family moved to Paris, Chéreau went to the Lycée Louis-le-Grand, where he started a theatre group for which he directed, acted and designed the decor and costumes.
At the age of 22, Chéreau became artistic director of the Théâtre de Sartrouville in a north-western suburb of Paris, where he met the designer Richard Peduzzi, who was to provide the decor of the majority of Chéreau's stage productions and films. The director placed much emphasis on the visual elements of his mise-en-scene, and the expressivity of the actors' bodies, sometimes using stylised gestures and grotesque makeup.
Chéreau's mentors were the great Italian stage director Giorgio Strehler, with whom he worked at the Piccolo Teatro di Milano (1970-72), and Roger Planchon, who appointed the 27-year-old as co-director of the TNP. Among his other influences were Bertolt Brecht, Antonin Artaud and Orson Welles.
That said, these influences were seldom reflected in Chéreau's eclectic filmography. But however one assesses his films, it is obvious that he set out successfully to disconcert audiences. For his first feature, the murky psychological thriller, Flesh of the Orchid (La Chair de l'Orchidée, 1975), based on James Hadley Chase's pulp-novel sequel to No Orchids for Miss Blandish, Chéreau, using some German Expressionistic visuals, assembled a starry cast including Charlotte Rampling, Edwige Feuillère, Simone Signoret and Alida Valli.
The Wounded Man (L'Homme Blessé, 1983) was a more personal project for Chéreau. He and his co-writer, Hervé Guibert, worked for six years on the scenario, which tells of a love affair between a teenage boy and an older man who is involved in prostitution. According to the director, this very dark view of homosexuality on the eve of the HIV/Aids epidemic is not a gay film but "a description of a closed milieu". As Chéreau, who lived with the actor Pascal Greggory for some years, told the Guardian journalist Stephen Moss: "I never wanted to specialise in gay stories and gay newspapers have criticised me for that. Everywhere love stories are exactly the same. The game of desire, and how you live with desire, are the same."
In contrast to the rather melancholy mode of his first few films, La Reine Margot was a rumbustious adaptation of the Alexandre Dumas novel set during the religious war between the Catholics and the Protestants in late-16th-century France. With its battle scenes, sumptuous settings and depiction of the St Bartholomew's day massacre, it was Chéreau's most expensive and – at 161 minutes – longest film and his biggest box-office success by far. It led to a whole series of historical epics from France.
On a smaller scale and with much handheld camerawork, Those Who Love Me Can Take the Train (Ceux Qui M'Aiment Prendront le Train, 1998), about the interplay of assorted characters on their way to the funeral of a misanthropic, bisexual minor painter (Jean-Louis Trintignant), was melodramatic, sentimental and emptily wordy.
Chéreau's only English-language film, Intimacy (2001), based on short stories by Hanif Kureishi, consisted mainly of loveless, graphically depicted, sexual encounters between a divorced father (Mark Rylance) and a housewife (Kerry Fox) in a grotty London flat. The film, inevitably dubbed Last Tango in London, gained some notoriety because of the unsimulated oral sex performed.
His Brother (Son Frère, 2003) centres on the relationship between two estranged brothers, one gay, the other straight. They come together when the latter suffers from a potentially fatal blood disease. The hospital processes are shot unflinchingly, without sentimentality, which makes this meditation on mortality even more moving. Chéreau's last feature, Persecution (2009), the title of which he describes as a synonym for love, was a gloomy, episodic film, in which a group of lonely people try to interact.
In May 2011, Chéreau came to the Young Vic theatre in London to direct I Am the Wind, a 70-minute two-hander written by the Norwegian Jon Fosse, which Michael Billington in the Guardian found "hypnotic", admiring the production's "visual bravura".
Chéreau acted in a few films, among them Andrzej Wajda's Danton (1982) playing Camille Desmoulins, and in Youssef Chahine's Adieu Bonaparte (1985), as Napoleon. For many years, Chéreau planned to make a film with Al Pacino as Napoleon in exile on St Helena, but he abandoned the project in 2009, when financing was not forthcoming.
• Patrice Chéreau, stage, film and opera director, born 2 November 1944; died 7 October 2013
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