Fractures, cuts, and abrasions wound the body, but madness undermines the mind, spirit, and personality. Suffering from madness can be terrifying, causing those afflicted to act contrary to their desires or reason. Madnesses are afflictions, similar in structure to poisons, diseases, and curses. They are used as part of the sanity system (see page 12) as an outcome of severe assaults on a character’s sanity, but GMs can use madness in other cases as well. Because madnesses are presented as afflictions, they can be used with the sanity and madness system found on pages 250–251 of the Pathfinder RPG GameMastery Guide.

If you’re using the rules for sanity and madness in the GameMastery Guide, when those rules call for a character to gain an insanity, roll d%. The character gains a lesser madness on a roll of 1–70%, and a greater madness on a 71–100%. Once the potency of the madness is determined, roll on the appropriate table (Table 5–1 for a lesser madness and Table 5–2 for a greater madness) to determine the kind of madness the character gains, or select an appropriate madness that fits the situation. The madnesses in this section are works of fantasy. None are statements about or descriptions of existing maladies.

READING A MADNESS STAT BLOCK

Madnesses are formatted in the same way as other afflictions (Pathfinder RPG Core Rulebook 555), with the following changes.

Save: Unless the character has gained the madness via the sanity system (see page 12), this is the save necessary to avoid contracting the madness. It is also the base saving throw needed to cure the madness (see Curing Madness below) and the saving throw the effects of the madness require. If, during the course of treating a madness, the affliction’s DC decreases, that new reduced saving throw also becomes the DC the afflicted character must succeed at to avoid any of the madness’s effects. It’s possible to suffer from multiple forms of the same madness. If a character becomes afflicted with a form of madness from which he is already suffering (even if it takes a slightly different form, such as phobias of different objects), the current DC of that madness increases by 5. All madnesses are mind-affecting effects.

Onset: When a character suffers madness from the sanity system (due to a sanity attack that deals sanity damage greater than or equal to his sanity edge), this onset time does not apply. Use this entry only when the character contracts the madness in other ways. During the onset time, the character gradually gains the madness effect, rather then suddenly experiencing the full effect after a number of days.

Effect: This is the effect of the madness. An afflicted character typically suffers this effect at all times, but some madnesses manifest only during certain situations. For complex effects or effects that rely on roleplaying, the description section of the madness contains a more detailed description of the effect. If you’re using the sanity system, this effect manifests as long as the madness is not dormant.

Dormancy Effect: If you’re using the sanity system, the afflicted character suffers this effect while the madness is dormant. Otherwise, ignore this entry.

Table 5–1: Lesser Madness
d%Madness
1–10Delirium
11–22Delusion
23–32Fugue
33–42 Hallucination
43–54Mania
55–66Melancholia
67–76Night terrors
77–86Paranoia
87–100Phobia

Table 5–2: Greater Madness
d%Madness
1–18Amnesia
19–30Catatonia
31–48Cognitive block
49–66 Disassociated identity
67–78Psychopathy
79–85Psychosomatic loss
86–100Schizophrenia


CURING MADNESS

Each madness has a DC representing its strength. Among other things, that DC specifies the saving throw the afflicted character must succeed at to recover from the madness. Recovering from a madness without magical aid is a lengthy process requiring significant rest. After 7 consecutive days of uninterrupted rest, the afflicted character can attempt a Will save against the madness’s current DC. If she succeeds, the DC is reduced by a number of points equal to 1/2 the character’s Charisma modifier (minimum 1). Instead of relying on her own strength of personality to reduce the effects of madness, a character can also seek out a single confidante, priest, or other advisor. The recovering character must meet with that person regularly (at least 8 hours each day) and gain guidance during the 7 days of rest. At the end of the rest period, the ally can attempt a Wisdom or Intelligence check (whichever is higher) with a DC of 15 for a lesser madness or a DC of 20 for a greater madness. On a success, the recovering character can reduce the madness’s DC by 1/2 the ally’s Wisdom or Intelligence modifier (whichever is higher, minimum 1) in addition to the decrease for resting. The character suffers the madness’s effect until the DC is reduced to 0.

Certain spells can also aid in recovery from madnesses or cure them outright. Lesser restoration has no effect on greater madnesses, but reduces the current DC of one lesser madness afflicting the target by 2, up to once per day. Restoration and heal reduce the current DC of one lesser madness afflicting the target by 5 or of one greater madness afflicting the target by 2, up to once per day each. Greater restoration, limited wish, and psychic surgeryOA all either cure the target of all lesser madnesses or reduce the DC of one greater madness by the spell’s caster level (caster’s choice), while miracle or wish immediately cure a target of all lesser and greater madnesses.

LESSER MADNESSES

Lesser madnesses tend to have less debilitating effects.



Delirium
  • Type lesser madness ; Jet de sauvegarde Volonté DD 16
  • Incubation 1d4 jours
  • Effet –2 penalty on Wisdom- and Intelligence-based checks; cannot take 10 or 20 on any check
  • Dormancy Effect None
    DESCRIPTION
  • A character suffering from delirium experiences decreased cognition and attention. Often she has no real sense of this decline, or feels extremely frustrated when she does realize her concentration is impaired. Physical diseases, poisons, and ailments can also cause delirium.
DELUSION
  • Type folie mineure ; Jet de sauvegarde Volonté DD 16
  • Incubation 2d6 jours
  • Effet mThe afflicted character believes something that is not true, and no amount of evidence can dissuade him of the belief.
  • Dormancy Effect None
    DESCRIPTION
  • A delusion is the persistence of a belief that no amount of
    evidence to the contrary can dissuade the afflicted character from
    having. The belief is often that another specific person either
    loves or wants to harm the afflicted character, or the afflicted
    character may have an inflated view of his own abilities or
    importance. Sometimes the deluded character believes he suffers
    from an affliction or persecution that does not exist.
    The exact nature of the delusion is decided by the GM. Delusions
    are typically roleplayed, though a GM might apply penalties to skill
    and ability checks having to do with the delusion, or decide that
    such checks fail outright because of the character’s delusion. In
    some circumstances, delusions can be debilitating, while in others
    they are merely quirky or annoying to those around the character
FUGUE
  • Type folie mineure ; Jet de sauvegarde Volonté DD 18
  • Incubation 1d4 jour
  • Effet 2 penalty on Will saving throws and skill checks, and some memory loss (see below)
  • Dormancy Effect –2 penalty on Will saving throws
    DESCRIPTION
  • character suffering from a fugue cannot remember things; her
    name and her past are all equal mysteries. While the character
    can build new memories, she has trouble accessing those gained
    before she was inflicted with this madness. While a character in
    a fugue state can still speak and read any languages she knows
    and does not lose any of her skills, feats, or skill ranks, she does not remember how she learned such things, and is often
    surprised when using complex abilities.

HALLUCINATION
  • Type folie mineure ; Jet de sauvegarde Volonté DD 14
  • Incubation 2d6 jours
  • Effet –4 penalty on any Will saving throw against or to disbelieve illusions, and illusions of things that are not there (see below)
  • Dormancy Effect The afflicted character takes a –2 penalty on Will saving throws against or to disbelieve illusions.
    DESCRIPTION
  • Hallucinations can affect all of the senses, but some of the most
    potentially debilitating are auditory hallucinations, where the
    afflicted character hears voices talking in his head, and visual
    hallucinations, where the afflicted character sees things that
    aren’t there. Most hallucinations are intermittent and produce a
    muddling of reality.

Toc/Phobie
  • Type folie mineure ; Jet de sauvegarde Volonté DD 14
  • Incubation 1 jour
  • Effet pEach round when an afflicted character is within 30 feet
    and can see the object of her mania, she must succeed at a
    Will saving throw or rush to interact with that object. If the
    afflicted character succeeds at the saving throw by 5 or more,
    she can keep away from the object of the mania or resist
    the manic activity for 1 minute before having to attempt the
    saving throw again. After failing a saving throw and fully
    performing the mania’s compulsion, the afflicted character
    need not attempt another saving throw for 1 minute, as she
    has temporarily satisfied her obsession.
  • Dormancy Effect Each round when an afflicted character is
    within 30 feet and can see the object of her mania, she must
    attempt a Will saving throw. If she fails, she can choose to
    either interact with the object of her mania (as above) or
    become fascinated by the object while abstaining from the
    activity for 1 round. If the afflicted character succeeds at this
    saving throw by 5 or more, she can’t be fascinated by that
    particular stimulus for 24 hours before having to attempt the
    saving throw again (for instance, if a character obsessed with
    swords succeeded at her save against a particular sword by
    5 or more, she wouldn’t be fascinated by that sword for 24
    hours, but she might be fascinated by other swords).
    DESCRIPTION
  • A mania is an irrational and unhealthy obsession with an object
    or activity. Nearly any object or activity can become the object
    of a mania, but often the object is either dangerous (like fire or
    deadly magic) or somewhat taboo (like the need to commit
    small thefts or engage in risky sexual behavior). The GM
    determines the exact nature of the mania, but it should
    have some connection to the madness’s impetus and be
    respectful to the narrative sensibilities and maturity of the
    player and the group.
Mélancolie
  • Type folie mineure ; Jet de sauvegarde Volonté DD 14
  • Incubation 1d4 jours
  • Effet l–2 penalty on initiative checks, and morale bonuses are halved (minimum +0)
  • Dormancy Effect None
    DESCRIPTION
  • A character suffering from melancholia struggles with severe
    pessimism and can often be slow to respond to threats and events
    going on around him. He can seem quiet and withdrawn, and
    his sense of enthusiasm is dulled. In extreme cases, a character
    suffering from melancholia becomes entirely introverted and
    utterly withdrawn, even to the point of near catatonia.

NIGHT TERRORS
  • Type folie mineure ; Jet de sauvegarde Volonté DD 16
  • Incubation 1 jour
  • Effet Each night when the afflicted character sleeps, she must succeed at a saving throw or wake up fatigued (see below).
  • Dormancy Effect None
    DESCRIPTION
  • A character suffering from night terrors is plagued by persistent
    terrifying dreams, worry, or terror that impedes her from getting
    restful sleep. Each night the afflicted character must succeed at
    a saving throw or wake up fatigued, though multiple nights of
    night terrors do not increase the condition to exhausted, and an
    exhausted character with night terrors wakes up after 8 hours of
    sleep either rested or fatigued based on the success or failure of
    the saving throw for this affliction. Often a character suffering from
    night terrors will bolt upright during sleep, eyes open, and scream,
    though less-dramatic symptoms are also possible. A character
    who awakens fatigued from night terrors doesn’t count as having
    had a good night’s rest for the purpose of preparing new spells,
    and she can’t remove the fatigue until she gets a good night’s
    rest by succeeding at the Will save against night terrors.

PARANOIA
  • Type folie mineure ; Jet de sauvegarde Volonté DD 17
  • Incubation 2d6 jours
  • Effet The afflicted character gains a +2 bonus on saving throws
    against charm effects, but takes a –2 penalty on Bluff, Diplomacy,
    and Sense Motive checks. When the afflicted character attempts
    a Sense Motive check, the GM rolls the check in secret, and
    failure gives the afflicted character the impression that those
    whose motives he is trying to sense are plotting against him
    in some way. Lastly, any time the afflicted character tries to
    use or gain a benefit from the aid another action, or is the
    target of a beneficial spell or effect from an ally, he must
    succeed at a Will saving throw in order to take the aid another
    action or gain the benefit from the action, spell, or effect.
  • Dormancy Effect The afflicted character gains a +2 bonus on
    saving throws against charm effects, but takes a –2 penalty on
    Bluff, Diplomacy, and Sense Motive checks.
    DESCRIPTION
  • A paranoid character is convinced that the world and society are
    conspiring toward his ruin. Typically those afflicted with paranoia
    are fidgety, argumentative, sullen, or extremely introverted.

Mélancolie
  • Type folie mineure ; Jet de sauvegarde Volonté DD 14
  • Incubation 1 jour
  • Effet Each round an afflicted character is within 30 feet and
    can see the object of her phobia, she must succeed at a Will
    saving throw or become shaken. The next round, the afflicted
    character can choose to attempt another saving throw to end
    the effect, but if she fails, she becomes scared (see page 10)
    instead. A scared character can choose to attempt another
    saving throw to become shaken again, but if she fails, she
    becomes frightened for 1d6 rounds instead.
  • Dormancy Effect Each round an afflicted character is within 30
    feet and can see the object of her phobia, she must succeed
    at a Will saving throw or become shaken for 1 round. If the
    afflicted character succeeds at this saving throw by 5 or more,
    that particular stimulus can’t cause her to become shaken for
    24 hours before having to attempt the saving throw again (for
    instance, if a character has a phobia of spiders and succeeds at
    her saving throw by 5 or more after seeing the wizard’s spider
    familiar, she doesn’t need to attempt another saving throw
    against the familiar for 24 hours, but she would still need to
    attempt a saving throw if she saw a different spider).
    DESCRIPTION
  • A phobia is an irrational fear of an object or activity. Nearly any
    object or activity can become the focus of a phobia, but often the
    object is either very specific (like all spiders, no matter how big or
    small, or clowns) or something that could be hazardous in some
    situations (like heights or water) but could be made relativity safe
    with magical or mundane precautions. The GM determines the
    exact nature of the phobia, but it should have some connection to the madness’s impetus and be respectful to the narrative
    sensibilities and maturity of the player and the group.



GREATER MADNESS

Greater madnesses can be extremely debilitating.

AMNESIA
  • Type folie majeure ; Jet de sauvegarde Volonté DD 22
  • Incubation immédiat
  • Effet ––4 penalty on Will saving throws and skill checks, and loss of memory (see below)
  • Dormancy Effect Unlike other madnesses, the normal effect and the dormancy effect of amnesia are the same.
    DESCRIPTION
  • A character suffering from amnesia cannot remember things; his
    name, skills, and past are all equal mysteries. While the character
    can build new memories, he has trouble accessing those gained
    before he contracted amnesia. While a character with amnesia can
    still speak and read any languages he knows, and doesn’t lose the
    most basic of skills needed to care for himself and interact within
    society, he cannot remember anything substantial about his past.
    A character with this affliction loses all class abilities, feats,
    and skill ranks gained before contracting amnesia. He retains
    his base attack bonus, saving throws bonuses (though he takes
    a –4 penalty on Will saves), CMB, CMD, total XP, Hit Dice, and
    hit points. If a character gains a character level while suffering
    from amnesia, he can use any abilities gained via that class level
    normally. If the class level he gained was of a class in which he
    already had levels, he initially gains the abilities of a 1st-level
    character of that class, even though he is technically of a higher
    level in that class, and then progresses from there. When the
    amnesia is cured, the character regains the full abilities of the
    class; recalculate his level based on his total XP.
CATATONIA
  • Type folie majeure ; Jet de sauvegarde Volonté DD 24
  • Incubation immédiat
  • Effet The afflicted character acts as if she were cowering, but this is not a fear effect, unlike other forms of cowering.
  • Dormancy Effect The afflicted character is staggered.
    DESCRIPTION
  • A character suffering from catatonia mentally shuts down completely, or nearly so, greatly limiting her physical capabilities
    as well. While a catatonic character still breathes, she can eat
    or drink without assistance only if the catatonia is dormant. If a
    catatonic character is faced with a dangerous situation, she must
    attempt a saving throw. If she succeeds, she acts as if panicked
    (though this is not a fear effect) until she is out of line of sight of
    the danger or is cornered. If she is cornered, she cowers again.
COGNITIVE BLOCK
  • Type folie majeure ; Jet de sauvegarde Volonté DD 20
  • Incubation instantané
  • Effet The afflicted character can no longer speak or write and has
    difficulty concentrating. He can no longer use command word
    items, spell-trigger items, or spell-completion items. He takes a
    –10 penalty on concentration checks. He cannot cast spells with
    a verbal or thought (Pathfinder RPG Occult Adventures 144)
    component, and cannot prepare spells from a spellbook
  • Dormancy Effect The afflicted character takes a –4 penalty on
    concentration checks.
    DESCRIPTION
  • This affliction deprives a character of his concentration and his
    ability to speak, read, and write, though he can understand words
    he hears and can react to requests and commands as normal.
DISSOCIATED IDENTITY
  • Type folie majeure ; Jet de sauvegarde Volonté DD 20
  • Incubation 2d6 jours
  • Effet –6 penalty on Will saving throws and Wisdom-based
    checks, and disassociated identities (see below)
  • Dormancy Effect –2 penalty on Will saving throws and Wisdombased
    checks
    DESCRIPTION
  • This is a complicated affliction that manifests as two or more
    distinct and different personalities in the same mind. The
    number of personalities is up to the GM, as is the nature of the
    personalities. Should the affliction worsen in some way (such as
    by gaining dissociated identity again), the number of additional
    personalities might increase as well.
    Each morning upon waking and each time the afflicted character
    is revived from unconsciousness, she must succeed at a Will save, or
    one of the character’s other personalities takes hold. If the afflicted
    character has more than one personality because of this madness,
    the manifested personality is either randomly chosen or chosen
    by the GM. If the afflicted character succeeds at all her saving
    throws against manifesting alternate personalities for 3 consecutive
    days, there is a 10% cumulative chance each night thereafter that
    another personality takes control during the character’s sleep,
    returning to bed afterwards and leaving the character with less
    sleep than expected; if the afflicted character fails a saving throw,
    the cumulative chance resets. The afflicted character’s memories,
    skills, and other abilities are unaffected by the personality shift, but
    typically the various personalities have no knowledge of each other
    and will deny, often violently, that the other personalities exist.
MORAL INSANITY
  • Type folie majeure ; Jet de sauvegarde Volonté DD 22
  • Incubation 3d6 jours
  • Effet The afflicted character’s alignment shifts to evil, and he
    gains a +10 competence bonus on Bluff checks to hide this
    madness. Once per day, the afflicted character can attempt a
    Will saving throw to suppress this effect for 24 hours.
  • Dormancy Effect None
    DESCRIPTION
  • This complex madness fills the afflicted character with hatred for the
    world and a detached feeling about others, as if they were nothing
    more than pawns for the afflicted character’s own uses. A character
    afflicted by moral insanity might plot the demise of friends and
    enemies alike, but always with the goal of avoiding blame or
    consequences and enabling him to continue to feed his dark desires.
    The impact of moral insanity must be roleplayed, although not all
    players may find it fun or interesting to play such a character. In such
    cases, the GM should assume control of the character whenever the
    madness is dominant. Evil characters can’t gain this madness
PSYCHOSOMATIC LOSS
  • Type folie majeure ; Jet de sauvegarde Volonté DD 20
  • Incubation Instantané
  • EffetThe afflicted character becomes blinded or deafened, loses
    another special sense (like scent or blindsense), loses the use
    of limbs, or loses a special movement speed (like a fly or swim
    speed). The GM chooses how the psychosomatic loss manifests.
  • Dormancy Effect None
    DESCRIPTION
  • While there is nothing physically wrong with the afflicted
    character, some kind of mental trauma has forced her brain to
    shut down sensory or motor systems. Furthermore, magical effects
    that typically remove these conditions (such as remove blindness/
    deafness) have no effect on this madness; the madness must be
    cured in order to regain the senses or motor skills.
SCHIZOPHRENIA
  • Type folie majeure ; Jet de sauvegarde Volonté DD 22
  • Incubation 1d6 jours
  • Effet –4 penalty on Wisdom- and Charisma-based checks; cannot
    take 10 or take 20 on any check; chance of becoming confused
    (see below)
  • Dormancy Effect cannot take 10 or take 20 on any check
    DESCRIPTION
  • A character afflicted with schizophrenia can no longer function
    as he once did, dealing with sudden deficits in social skills and
    cognition, and an influx of new, strange behaviors. The character
    becomes erratic, chaotic, and unpredictable as his affliction and
    symptoms continue, often hitting a peak of symptoms including
    hallucinations and delusions. Each time a character afflicted
    with this madness finds himself in a stressful situation (such
    as combat), he must succeed at a Will saving throw or become
    confused for 1d6 rounds.