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* ParanoiaFuel: The ''Anomaly'' DLC introduced a hefty dose of this to the game, with things like invisible monsters that attack in packs, invisible monsters that hypnotize and abduct pawns (and can even ''open doors''), sinkholes suddenly opening up in the middle of your base to disgorge hordes of monsters, or other monsters that are basically Film/TheThing on steroids. That last one is a particularly nasty example. [[spoiler:Called Metal Horrors, they start off as a nanite infection that can lay dormant for years, meaning it's entirely possible for a pawn you recruited half a decade ago to already have them. Once the infection takes hold, the host starts infecting other pawns through a multitude of ways, like the meals they cook, injuries they treat, or simply through physical/intimate contact. This way the entire colony can be infected before the first Metal Horror ever reveals itself, and once the first one pops out, leaving the host grievously wounded with hours to live at best, all other hidden Horrors reveal themselves at the same time, potentially wiping out the whole colony in one fell swoop. The infection can be detected via a surgical inspection, but if the doctor performing the surgery is themself infected, they'll lie about the test results and potentially infect any uninfected pawn in the process. Oh, and your pawns can get infected with Horrors through ''any'' cut or bleeding wound from ''any'' ''Anomaly'' entity.]] If you've experienced an outbreak like this even once, you'll never feel safe about... well, just about anything in the game again.
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* ParanoiaFuel: The ''Anomaly'' DLC introduced a hefty dose of this to the game, with things like invisible monsters that attack in packs, invisible monsters that hypnotize and abduct pawns (and can even ''open doors''), sinkholes suddenly opening up in the middle of your base to disgorge hordes of monsters, or other monsters that are basically Film/TheThing on steroids. That last one is a particularly nasty example. [[spoiler:Called Metal Horrors, they start off as a nanite infection that can lay dormant for years, meaning it's entirely possible for a pawn you recruited half a decade ago to already have them. Once the infection takes hold, the host starts infecting other pawns through a multitude of ways, ways like the meals they cook, injuries they treat, or simply through physical/intimate contact. This way the entire colony can be infected before the first Metal Horror ever reveals itself, and once the first one pops out, out - leaving the host grievously wounded with hours to live at best, best - all other hidden Horrors reveal themselves at the same time, potentially wiping out the whole colony in one fell swoop. The infection can be detected via a surgical inspection, but if the doctor performing the surgery is themself infected, they'll lie about the test results and potentially infect any uninfected pawn in the process. Not only that, but you can only conduct the inspection in the first place after studying several samples, which takes more than enough time for one Metalhorror to become twenty. Oh, and your pawns can get infected with Horrors through ''any'' cut or bleeding wound from ''any'' ''Anomaly'' entity.]] If you've experienced an outbreak like this even once, you'll never feel safe about... well, just about anything in the game again. Even worse? Due to how the event generates, [[spoiler: there is ''nothing'' you can do to preemptively prevent the spread of infection. Even if your colony is entirely vat-grown and have never touched any infection vector, once the AI Storyteller decides to start a Metalhorror event, ''they're infected.'' Metalhorrors aren't an "if" question, they're a "when" inevitability.]]
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** Alzheimer's and Dementia, which ruins the mental faculty of your colonist. Unlike some of the other medical afflictions in the game, there is no way to cure these conditions, even with the ''Ideology'' DLC's biosculpter pod. Your only real option is to manage the condition and care for the colonist until they can't properly function any more, unless you have access to the extremely rare [[TooAwesomeToUse healer mech serum.]]
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** Alzheimer's and Dementia, which ruins the mental faculty of your colonist. Unlike some of the other medical afflictions in the game, there is no way to A cure these conditions, even with the ''Ideology'' DLC's biosculpter pod. Your only real option is to manage the condition and care for the colonist until they can't properly function any more, unless you have access to requires special items like the extremely rare [[TooAwesomeToUse healer mech serum.]]serum]] or the very risky drug Luciferium.
