This PDF contains 24 injuries and 36 madness for use with Elder Sign. They are all impactful without being crippling, although they could situationally be crippling. They are intended to be used to add difficulty and a bit of roleplaying feel to the game either acquired when a character would normally be devoured or as a personality trait to start the game.

Although created to use instead of being devoured, we found that the madnesses were fun and added some difficulty. So we play with characters starting the game with a madness (or injury). Most madnesses can be considered an extreme personality or a result of them learning about the mythos in the first place.

https://boardgamegeek.com/filepage/143711/injuries-and-madness-or-personalities