Those who are more familiar with PDQ from humorous games like Questers of the Middle Realms and Ninja Burger or whimsical rpgs like the Zorcerer of Zo or Truth and Justice may be a little surprised at the cover to the right and the rather bleak title here. Well, Dead Inside isn't your average PDQ game or your average RPG in general.
The game has a very unique concept tied to a twisted sort of urban fantasy and horror setting. Essentially the players are all characters who have lost their soul...perhaps they sold it, perhaps they were "broken" by some kind of horrific event or perhaps something simply cracked their soul like an egg and drained them dry. Souls insulate normal humans from the agonizing coldness of the Real World and those without this protection are left in constant, numbing pain. However, your soul also blinds you and limits you to your half-blind mundane senses and with that shroud lifted you can now see an entire world of horror, magic, madness and mystery.
The game is essentially a quest to restore your soul and end your torment. The expanded perception of the Dead Inside allows them to explore the Spirit World, interact with the Imagos (sort of weird, Jungian spirit-guides) and other supernatural beings such as ghosts and pure spirits. Dead Inside can trade soul-stuff and may restore themselves by making deals or even stealing soul-energy from others. However, the stated goal of the game is to reverse the standard RPG cliche of "kill things and take their stuff", because one of the ways you can restore your soul is by doing good deeds, helping others and "cultivating" your soul energy. Likewise acts of selfishness and viciousness are a good way to cause soul decay and stunt your growth.
In addition to your expanded perception the Dead Inside gain access to supernatural abilities that allow them to create changes in themselves or the world around them or create portals to the Spirit World. Of course these powers come at a price. They are fueled by Soul Energy...the resource that you're desperately trying to husband to make yourself whole.
The setting of Dead Inside is very evocative and imaginative while being drawn out namely in broad strokes. The main focus is on the Spirit World (although there is also the Cold Hard World sourcebook which provides extra information on the Real World) and it's a place that can be full of beauty, surrealism and subtle (or not-so-subtle) horrors. It's like a mixture of Wonderland, Labyrinth and Neil Gaimen's Mirrormask. The game doesn't end if you restore your soul either, as once you've fixed yourself you become a Sensitive, a fully-souled individual who can still perceive the supernatural and if you continue to develop your spiritual muscles then you can eventually evolve into a Magi, a much more powerful spiritualist capable of warping reality and others and creating new spirits from pieces of their own soul.
Now, I've spent most of this week fanboying-out over these games but for Dead Inside I think it's worth bringing up a few "cons". Dead Inside is a great setting and it's supported by the tough little PDQ system so it's still definitely worth the 13 bucks for the PDF but it is pretty much the first serious game for PDQ and it shows it. There's a variety of mechanics that are interesting but don't quite work. Far too much of the system is reliant on the Soul Point mechanic. The primary drive of the Dead Inside is restoring their soul and making themselves whole. However, Soul Points are also the primary form of currency in the Spirit World and the fuel for any supernatural tricks you might try. That means to really get involved with most of the really neat, weird and surreal aspects of the setting you've got to slow down your growth, which is hard to justify in-character. Likewise your Type Quality (Dead Inside for most PCs) is by far the most important Quality and it's impossible to improve other Qualities without actually reducing your Dead Inside Quality. At the same time it's actually quite easy to restore your soul, in fact you could probably do it in a handful of sessions, rendering the primary motivation and source of dread and angst slightly toothless.
However, despite those gripes you've got a truly inspiring setting with some neat, original mechanics that is well worth getting.
Bonus Material: Dead Inside House Rules
So as I mentioned, Dead Inside has some mechanics that work against it, it was made at a time when the PDQ system was just finding its legs and hadn't really hit its stride with things like Truth and Justice. So here's some suggestions on systems that could be spliced from other PDQ games to make things run smoother.
Soul Points (Truth and Justice): The biggest problem with Soul Points is the fact that they are simultaneously your only form of currency, the fuel for your supernatural tricks, your "luck" points and, against some supernatural beings, a form of hit points. On top of that you've got to try and accumulate as much as possible if you want to restore your soul. The best solution to this issue is to use the Truth and Justice Hero Point system in place of Soul Points. The standard Hero Point pool can be spent to power your supernatural abilities or engage in soul-point barter, while character progression is handled by the MAX. That way a Dead Inside doesn't have to worry about crippling their progression if he heal a friend or ward away a hungry spirit predator.
It also helps to explain one of the odd little paradoxes of the setting. A common object is a Soul Egg, a device made to hold Soul Points as a kind of storage device. However, there's little justification to actually create one of these or use them. There's no normal limit to the number of soul points you can hold and the soul egg itself actually can make you vulnerable (by acting as an arcane line to someone else who holds one of your Soul Eggs). However, having a Maximum pool of Soul Points means that Soul Eggs are a necessity for those who trade heavily in Soul Points or steal them from others.
When using Hero Points a character's Type Quality can be improved at a MAX cost equal to it's new MOD +2 (so 4 points to go from Average  to Good [+2], 6 to go from Good [+2] to Expert [+4], etc).
Qualities, Damage and Recovery (PDQ#) One thing that may strike you when reading the Dead Inside character creation rules if you're used to other PDQ games is how few Qualities they get. The core PDQ rules (especially back then) tended to assume a very small collection of Qualities for quick, pick-up-and-play style games. However, it's pretty easy to see that the number of Qualities (and thus the durability and competence of most characters) has usually increased since then.
So for character creation I suggest looking to PDQ# and it's Core Qualities. Each Dead Inside character should have a Good [+2] Past Quality, a Good [+2] Defining Quality and a Good [+2] Personality Quality (I dropped Motivation, since all Dead Inside share a single, driving Motivation to begin with) and a Quirk (same as PDQ#'s Foibles). Then each character receives 4 additional Quality Ranks to buy new Qualities or to increase one of their Core Qualities.
I would also suggest using PDQ#'s rules for damage (being taken out only once all Qualities are Zeroed Out) and recovery (including the rules for being Mostly Dead).