Everyone here has already covered the areas of how violent Mad World is. That's fairly obvious even from looking at the cover. HOWEVER, the WORST part about Mad World is the language used by the "announcers" in the game! The announcers give a sports like play-by play of what the player is doing and crack jokes: and this is most often in the form of sexually explicit analogies. I'm not just talking somewhat suggestive, I'm talking EXPLICIT. Some of them were unbelievably awful enough to make my jaw drop, and likewise, when my boyfriend was playing this game, he heard the announcers start to say a phrase he'd heard before and yelled random noises at the top of his lungs to keep everyone from hearing it because he knew it would be upsetting! The violence in this game is a problem, yes, but the announcers are FAR WORSE!
Thankfully there is an option to turn the announcers off, but I have heard that the game becomes boring(as it has no music) after that.