The PlayStation versions of this game offer optional censorship and skipping with most of the aforementioned scenes. The main character has a miscarriage in bed. The player holds a severed head near the end of the game. Another cutscene depicts a man with bloody stumps for legs after running over a mine. The player personally disembowels a corpse to remove a deformed fetus. Another cutscene depicts a rotting, maggot-ridden corpse while another person is hanged in the background. A character model has the skin of her face peeled off, which players remove and wear in an interactive sequence.

Many disturbing scenes with blood and gore, sometimes with an uncomfortably protracted focus or an unusual tone depicting dismemberment and mutilation. Story also has two female characters who become violent and insane after pregnancy complications, which may be a coincidence, but it's an eyebrow-raising correlation.

Aspects of her condition are depicted accurately (such as child abuse being a common cause, and people like her displaying subtle rather than drastic changes in behavior), but there are unhelpful and contradictory stereotypes, such as a strong inclination to violence or constructing elaborate, fantastical realities. Main character has dissociative identity disorder (DID). Some Italian characters demonstrate ethnic prejudice against Germans for being Nazis, but game doesn't further explore theme of delineating people groups from causes. But being the young daughter of a Nazi in a commanding position, she's seemingly uninterested in this conflict and maintains a neutral stance even after witnessing Nazi soldiers murder her love interest.

Features a female lead who is self-determined to find justice for her sister.

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