Her self-harm tendencies become more pronounced due to the game's antagonist Monika influencing the in-game files, which culminates in her stabbing herself to death after confessing her love for the protagonist.

Her mental illness, particularly her self-harm tendencies, have received commentary from critics, with one writer identifying her death as one of the most shocking moments in a video game.

As the game progresses, signs of mental illness become more evident, including her obsession with the player character, exhibiting self-harm tendencies and concealing her cutting with long sleeves.

[3] Due to Salvato's lack of artistic skills at the time, he created the designs of Yuri and other characters in a free anime-creation program, which were used in a test version of the game.

[4] Salvato recognized that a product of such quality would not satisfy potential players, so he made a request to his friend, a translator for Sekai Project, for sketches of school uniforms and hairstyles for the characters.

After Kagefumi's departure from the project, Salvato contacted the freelance artist Satchely, who created the final character sprites over the course of the following few months.

When Natsuki eventually shows up, she throws up at the sight of Yuri's corpse, before Monika deletes both of their files from the game due to wanting the player all to herself.

Yuri returns as a playable character in Yandere Simulator,[8][9] taking the role of an obsessively lovesick schoolgirl nicknamed "Yandere-chan" who seeks to "eliminate" (kill) anyone she believes is attracting her "senpai's" attention.

[19] VG247 writer Ana Valens described her as "the classic shrinking violet," discussing how her traits begin to be corrupted by Monika over time, eventually turning her self-consciousness into self-harm.