
The year is 1923—step inside Castle Woods Sanatorium, where care and cruelty blur together. Disguised as a doctor, you’ll diagnose and treat patients using a deck of symptoms, tests, and outdated therapies. But tread carefully: one wrong move could expose you as an impostor.
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“Sanatorium: A Mental Asylum Simulator Is One of the Most Unique Games I’ve Ever Seen” - VICE
It’s the roaring twenties, an age of technological progress and social upheaval. As the city around you expands, you feel left behind: a weary journalist burdened by debt and drifting purpose. Then, out of the blue, a cryptic message arrives from a childhood friend—perhaps the tip of a lifetime. It points to the infamous Castle Woods Sanatorium. A mystery waits there, and you can’t shake the urge to uncover it. It may be nothing more than a hunch, but it feels like a secret that could change everything. Even you. The decision is made: you pack your bags and set out for Castle Woods.

Test your wit and intuition. Every week, new patient files present new puzzles to be solved as you decide which tests to use to uncover symptoms and which treatments you prescribe to cure them. Decide whether you want to follow the rule book or try out experimental new treatments with unknown outcomes. Do you want to be kind or cruel? Business savvy or risk-taking?
Uncover dark secrets behind the squeaky-clean facade of Castle Woods' walls. Meet helpless patients, ruthless opportunists, and an array of other intriguing characters. Collect clues and piece together the shocking truth about the Sanatorium and your own past.

Card-driven workplace sim — step into the role of a doctor in 1923, where every action is bound by the outdated tools and beliefs of the era.
Diagnose, “treat,” or withhold — decide whether to follow harsh, archaic methods or act with compassion, knowing both choices carry consequences.
Every patient is a puzzle — files unfold as layered card sets, with symptoms hidden, revealed, and misinterpreted through limited knowledge.
A full campaign across 4 chapters — uncover the secrets of Castle Woods and the lives caught within its walls.
Branching paths, multiple endings — your decisions shape not only patients’ outcomes, but your own fate as an impostor.
Over 100 cards to chart — symptoms, illnesses, tests, and treatments drawn from the unsettled history of psychiatry.
Evolve your treatment plan — upgrade treatments toward more humane practices, or double down on methods that protect your cover at any cost.

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Genres
Stats
All-time low is the lowest price we've recorded for this game since we started tracking it.
Languages: English, French, German, Spanish - Spain, Japanese, Korean, Portuguese - Brazil, Simplified Chinese, Italian, Russian
Engagement
Hours played at review time, across 40 reviews with recorded playtime.
Reviews
Themes across 40 recent reviews and how positive each mention is. A keyword signal, not full sentiment analysis.
positive critical· bar length = how often the theme comes up
Reviews
I would LOVE to recommend this to others. I love the art style, the mechanics, the whole thing. The core gameplay loop is extremely fun if you're willing to take down some notes for yourself for better reference. However. The game, as it is, is in desperate need of bug fixes and QoL. The developers seem to have listened to player feedback in the past, if you look at the patch notes, but it's simply not enough. Some things require you to pay attention, think, and strategize ahead - you can brick your run if you're not thinking about when and how much to treat. That's annoying, but fine, and something you learn from. What Doesn't help with this at all is the lack of option to manually save. If you reach a game over, you can either reset to the beginning of the day, or to the beginning of the section. If you've been unwise but got promoted, it doesn't matter if you reset to the beginning of the section, because you've been trapped in a corner. The inventory system. My first playthrough I didn't even realize that the little square in the bottom left Was my inventory, let alone that I had to drag items onto interactables. Again, game design can only get a player so far, but I definitely think a small popup would be helpful. But! If your inventory bugs out as mine did in Section 2, when I used an item to get another item, congratulations! You are now unable to access anything else but that bugged item! Certainly, you can pick items up, but they'll never appear for you to make use of. When key story decisions revolve around handing an NPC an item, this is a pretty big deal! One small thing, that could be toggled off if others don't like it, would be to add a small highlight border around interactables when moused over. Cards also disappear as you unlock new ones. I understand wanting to keep things concise and to one screen, but when I'm suddenly unable to get something that's locked behind a card because I wanted new options in the meantime, it doesn't feel good. I'd be happy with the ability to scroll through, or otherwise have to press buttons to see every option I have, even if it adds a bit to menuing. This is a point-and-click game anyways, menuing is already part of it. Maybe I'm not a "true gamer." I don't play tons of puzzle games for a living. But when I go to a discussion board and see that there's a whole separate area that I never encountered, and that there were hidden steps to do something that is necessary for the game, I feel like there needs to be more guidance. In addition, some story elements just don't come into play well, regardless of my ability to interact with them (due to bugged inventory.) There's a whole scene I missed in my second runthrough of Section 1 (second because I bricked my first runthrough) for no reason that I could discern - the event just Didn't Happen. The transition from Section 3 to Section 4 - maybe it's meant to be a total farce, but it just felt like I had missed another story trigger earlier to at least clue me in to how that transition would occur. Again, I really do like this game. I just think it can do so much better, and really want to see that. EDIT 4/12/26: Bugs mentioned above may have been fixed, as a bugfix update has come out since I last played.
Investigação, saúde mental e MUITA MUITA COISA NADA A VER aconteceu na ciência enquanto o ser humano entendia o que é doença e o que é saúde tanto fisica quanto mental e sanatorium vem aí para nos dar pequenas parcelas de uma realidade não tão longe da nossa realidade (2026). Se você é do tipo analista comportamental ou médico nas horas vagas ou até mesmo historiador, vem ver o meu video: https://www.youtube.com/watch?v=lPGkZEjXxQE&t=267s
二编:别买,不好玩。bug修了,但没有完全修。 游戏的核心流程存在极其致命的逻辑Bug,会导致玩家在后期陷入死档状态。这意味着无论你投入多少精力和时间,都无法正常触发并看到游戏的真实结局。游戏刚开始就跟我说要找阿姨,打倒结局阿姨都没有出现,跟我说要结局了,而且还结局不了。(这个现在已经修复了,但是还是存在一些不知道什么时候触发的机制和莫名其妙加入的要素。 本作的耐玩度极低,仅仅游玩半个小时后,就会发现后续几乎没有任何新内容或机制出现。游戏内部大量的场景和交互都显得极其空洞,明显只做了一半就仓促上架。第三第四章几乎没有任何新证据。 游戏的系统稳定性极其糟糕,Bug随处可见。最直观的证明就是,目前有多个成就的全球达成率竟然依然是0%!!这足以说明游戏的内部逻辑逻辑和达成条件存在根本性缺陷,导致玩家根本无法达成这些目标,现在还是没修,推荐修改器开成就。 此外,本作的翻译水平堪称灾难,存在大量生硬的、不符合中文逻辑的机翻痕迹。很多关于病症和诊断的关键描述翻译得词不达意,严重干扰了玩家对游戏逻辑的理解。中文玩家的体验感极差,基本上没法玩,但是如果你非要吃屎,我这里有一份机翻的攻略: 游戏诊断攻略: Impetus 动力 / 冲动(闪电图标) Kleptomania:偷窃癖 Lack of tactile control:触觉控制缺失 Physical tics:身体抽动 Voice tics:发声抽动 Involuntary tremors:不自主震颤 Aggressive behavior:攻击性行为 Convulsions:惊厥 / 抽搐 Fainting:晕厥 Excitation:兴奋 Inappropriate behavior:不礼貌 / 不当行为 Incontinence:失禁 Irritability:易怒 Loss of control:失去控制 Nail-biting:咬指甲 Ratio 理智 / 判断力(齿轮图标) Isolated genius:孤僻的天才 Catatonia:紧张症 / 木僵 Apathy:冷淡 / 漠然 Judgment impairment:判断力受损 Math impairment:数学能力受损 Reading impairment:阅读能力受损 Self-harm:自残 Unreliable:不可靠 Opiate abuse:鸦片滥用 Mild intoxication:轻度中毒 / 醉酒 Intoxication:中毒 / 醉酒 Sadness:悲伤 Gambling addiction:赌博成瘾 Memoria 记忆 / 核心(漩涡图标) Short-term memory problems:短期记忆问题 Long-term memory problems:长期记忆问题 Unexplained muteness:不明原因的沉默 Over talkative:多话 / 话痨 Disorientation:方向感迷失 / 定向障碍 Forgetfulness:健忘 Slurred speech:言语不清 Stuttering:结巴 Lack of sense of time:缺乏时间感 Selective mutism:选择性缄默 Selective amnesia:选择性失忆 Short-term amnesia:短期失忆症 Philia 癖好 / 爱欲(心形图标) Compulsive masturbation:强迫性手淫 Delusional love:妄想出的爱情 Emotionlessness:缺乏情感 Uranian love:同性之爱(时代术语) Misanthropy:厌恶人类 Constant libido:持续性性欲 Sadism:施虐癖 Objectophilia:恋物癖 Lack of empathy:缺乏共情 / 同情心 Lack of libido:性欲减退 Obsession with money:金钱痴迷 Obsession with fire:纵火癖 Obsession with cleanliness:洁癖 Masochism:受虐癖 Necrophilia:恋尸癖 Phobia 恐惧(眼睛图标) Chaotic reactions:混乱反应 Fear paralysis:恐惧性瘫痪 Fear of heights:恐高症 Fear of human contact:恐惧他人接触 Fear of large open spaces:广场恐惧症 Fear of the dark:怕黑 Fear of spiders:恐蛛症 Shortness of breath:呼吸急促 Nervous tics:神经性抽动 Panic attacks:恐慌发作 Acoustophobia:恐音症 Excessive sweating:出汗过多 Fear of germs:恐菌症 Fear of enclosed spaces:密集 / 密闭空间恐惧 Abnormally rapid heartbeat:心跳异常加速 Mania 躁狂 / 幻想(星星图标) Delusions of jealousy:嫉妒妄想 Imaginary friends:幻想中的朋友 Imaginary threats:幻想中的威胁 Insomnia:失眠 Nightmares:噩梦 Religious visions:宗教幻象 Speaking incomprehensible languages:胡言乱语 / 讲难懂的语言 Demonic possession:恶魔附身 Fatigue:疲劳 Hallucinations:幻觉 Hearing voices:幻听 Hypersomnia:嗜睡 Sleepwalking:梦游 Pathological lying:病理性说谎 Derealization:现实解体 Ego 自我 / 人格(大脑图标) Lack of eye contact:缺乏眼神接触 Dependence on fasting:禁食依赖 / 绝食 Personality changes:人格改变 Low self-esteem:自卑 Depersonalization:人格解体 Perfectionism:完美主义 Ideatory fixation:观念固着 Excessive self-esteem:过度自信 / 狂妄 Inflexibility:僵化 Bulimia:暴食症 Unhygienic:不卫生 Food addiction:食物成瘾
---{ Graphics }--- ☐ You forget what reality is ☐ Beautiful ☑ Good ☐ Decent ☐ Bad ☐ Don't look too long at it ☐ MS-DOS ---{ Gameplay }--- ☐ Very good ☑ Good ☐ It's just gameplay ☐ Mehh ☐ Watch paint dry instead ☐ Just don't ---{ Audio }--- ☐ Eargasm ☐ Very good ☑ Good ☐ Not too bad ☐ Bad ☐ I'm now deaf ---{ Audience }--- ☐ Kids ☑ Teens ☑ Adults ☐ Grandma ---{ PC Requirements }--- ☐ Check if you can run paint ☑ Potato ☐ Decent ☐ Fast ☐ Rich boi ☐ Ask NASA if they have a spare computer ---{ Difficulty }--- ☐ Just press 'W' ☐ Easy ☐ Easy to learn / Hard to master ☑ Significant brain usage ☐ Difficult ☐ Dark Souls ---{ Grind }--- ☐ Nothing to grind ☐ Only if u care about leaderboards/ranks ☐ Isn't necessary to progress ☑ Average grind level ☐ Too much grind ☐ You'll need a second life for grinding ---{ Story }--- ☐ No Story ☐ Some lore ☑ Average ☐ Good ☐ Lovely ☐ It'll replace your life ---{ Game Time }--- ☐ Long enough for a cup of coffee ☐ Short ☑ Average ☐ Long ☐ To infinity and beyond ---{ Price }--- ☐ It's free! ☐ Worth the price ☑ If it's on sale ☐ If u have some spare money left ☐ Not recommended ☐ You could also just burn your money ---{ Bugs }--- ☐ Never heard of ☐ Minor bugs ☑ Can get annoying ☐ ARK: Survival Evolved ☐ The game itself is a big terrarium for bugs ---{ ? / 10 }--- ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5 ☐ 6 ☑ 7 ☐ 8 ☐ 9 ☐ 10
На данный момент у игры встречаются критические баги. Например, я застряла на экране итогов дня после 5 часов игры. Кнопка продолжить не реагирует ни на какие нажатия. И всё, переигрывание дня приводит к тому же результату. Также игру фризило при переносе карточек на рабочем столе после 3х часов игры, ребут решил проблему. В целом игра любопытная, ее хочется пройти до конца, но опять тратить 5 часов, чтобы дойти до 10 дня 4 палаты в надежде не словить баг убивает всё желание.
I really like the general gameplay loop and the art style, but the game is riddled with senseless bugs and no way to save your game at any point (it saves at the end of each in game day). I feel like 70% of my play time was just reloading to try and get past bugs. It appears that the dev team has not gotten an update shipped since January. If you're thinking of buying this game, just wait until you see reviews that are clear of bug issues because this is in no way shape or form a finished game.
игра с замечательной концепцией, но ужасными багами. Пропадают квестовые предметы, не скипаются предметы, залипание меню и строк диалогов.
Забаговано критически, не покупай пока. Пришлось бросить своих пациентов без целительной лоботомии.
I want to like it, I do.. there are good points. It feels like it could be interesting. If you do want to play it, take notes as you go However, it plays HORRIBLY badly on Deck and I just hit a game breaking bug trying to play on PC. I cannot recommend this game
Очень классная игра, интересный сюжет и механики, но я в пятый раз из-за багов не могу пройти игру до конца. Застреваю то тут, то там. Сейчас забаговалось на 4 отделении. Потенциал супер, но количество багов все убивает.
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Audience
Estimated from the language of this game's reviews — a proxy for where players are, not official Steam demographics.
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