What changes
- No player marker and no cardinal directions; the compass is a circle with quest markers only when you are close.
- No fast travel and no autosave: saving is Saviour Schnapps, your own bed, a bathhouse full service or quitting the game (Warhorse).
- Health, stamina and hunger are felt, not shown; injuries are worse and heal slower.
- Combat: no directional indicator on enemies and harder hits.
- At least two negative perks chosen at the start and kept for the whole game — Nightmares, Claustrophobic, Hemophilia, Brittle Bones, Consumption, Somnambulant, Numbskull, Tapeworm and Shakes are the set the wiki lists.
Choosing
- Numbskull (slower experience) and Tapeworm (more food) are the ones that make the game longer rather than shorter.
- Nightmares and Somnambulant cost you sleep and place; Hemophilia and Brittle Bones cost you fights.
- The sequel copied the idea and kept the names of two: Somnambulant and Numbskull.