Madness is a possibility in the back of either the CRB or the GMG. Is it expected that a ranking cleric throws a restoration on you and poof; Wis restored and no harm/no foul, or are there full on asylums where the insane are housed, treated and studied?
I would be very surprised if everyone with mental illness were able to afford greater restoration, a 7th level cleric spell. Even if restoration alone were sufficient, it's too expensive. The material components by themselves would make it prohibitively expensive.
So, yes, asylums for the vast majority of the insane.
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There's also Carrion Hill, which despite the name, wasn't part of the Carrion Crown AP.
Pretty sure there's an asylum featured in that adventure, and it's by fan-favourite Richard Pett, so begins with a creep factor 11 by default.
Creative Director
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Refining the OP's question:
Are there any asylums on Golarion that are actually good at treating mental illnesses? Or all of them pointing over to Arkham Asylum and saying "Hey, at least we're not them!"
There absolutely are.
Those ones are terrible boring choices to feature in adventures though, so you won't see us talk much about them.
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Yeah, places where they help you and others? Bahh...who wants that? Now somewhere where madmen eat flies, scream at all hours and crawl on the walls before exploding into hungering undead or tentacled horrors... that one's got legs...
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Hah. Carrion Hill was actually the one I was trying to call out, not Carrion Crown. But yeah... Carrion Hill is in fact the BEST one to get if you're looking for an asylum adventure.
I assumed you were calling out the first chapter of Carrion Crown, which would be a good match, since it's set inside a jail.
Most of the prisoners seem to have been two sandwiches short of a picnic, so it could easily be designated an asylum as well.| 1 person marked this as a favorite. |
Surgeons washing their hands: Semmelweis.
Mentally ill treated humanely: Pinel.
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Where Madness Dwells is a d20 adventure set in an asylum, and available for free at Drivethrurpg.
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There's also Carrion Hill, which despite the name, wasn't part of the Carrion Crown AP.
Pretty sure there's an asylum featured in that adventure, and it's by fan-favourite Richard Pett, so begins with a creep factor 11 by default.
Actually, Runelords 2, Carrion Crown 2, and Carrion Hill all have asylums, and all are by Richard Pett...
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Actually, Runelords 2, Carrion Crown 2, and Carrion Hill all have asylums, and all are by Richard Pett...There's also Carrion Hill, which despite the name, wasn't part of the Carrion Crown AP.
Pretty sure there's an asylum featured in that adventure, and it's by fan-favourite Richard Pett, so begins with a creep factor 11 by default.
I don't believe that's a coincidence. ;)
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Refining the OP's question:
Are there any asylums on Golarion that are actually good at treating mental illnesses? Or all of them pointing over to Arkham Asylum and saying "Hey, at least we're not them!"
There absolutely are.
Those ones are terrible boring choices to feature in adventures though, so you won't see us talk much about them.
Yeah, I know, just had to address the obvious point. It's sort of like one of my least favorite quotes that gets tossed around in horror literature: "He came back wrong."
In the history of horror lit, has anyone ever come back right?
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I don't believe that's a coincidence. ;)Actually, Runelords 2, Carrion Crown 2, and Carrion Hill all have asylums, and all are by Richard Pett...There's also Carrion Hill, which despite the name, wasn't part of the Carrion Crown AP.
Pretty sure there's an asylum featured in that adventure, and it's by fan-favourite Richard Pett, so begins with a creep factor 11 by default.
Turns out, when we assign adventures, we assign them to the authors who are the best fit.
I've been working with Richard for over a decade, and while I think his greatest strength is actually humor, believe it or not... he's a damn awesome creator of freaky asylums!
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I've been working with Richard for over a decade, and while I think his greatest strength is actually humor, believe it or not... he's a damn awesome creator of freaky asylums!
And here I thought it was a case of "write what you know." ;)
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Are there any properly run, humane asylums that actually help their patients? I'm coming up blank there, though I'd imagine Magnimar and Absalom would be two of the more likely places to have them.
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Are there any properly run, humane asylums that actually help their patients? I'm coming up blank there, though I'd imagine Magnimar and Absalom would be two of the more likely places to have them.
Havenguard Lunatic Asylum in Caliphas (as touched upon in Rule of Fear) seems rather benevolent.
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Turns out, when we assign adventures, we assign them to the authors who are the best fit.
I've been working with Richard for over a decade, and while I think his greatest strength is actually humor, believe it or not... he's a damn awesome creator of freaky asylums!
He runs a funny game as well, so it's not just the writing, though the writing gives plenty of opportunities for players to get themselves into trouble.
If you get the chance to sit at his table, do.
One of the best one-shot Call of Cthulhu adventures I ever ran was actually played in the staff room of an emergency psychiatric ward during a slow night shift.
...Sorry, that went a little off-topic. Now back to your regularly scheduled mayhem!
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Are there any properly run, humane asylums that actually help their patients? I'm coming up blank there, though I'd imagine Magnimar and Absalom would be two of the more likely places to have them.Havenguard Lunatic Asylum in Caliphas (as touched upon in Rule of Fear) seems rather benevolent.
Yeah, Havenguard's run by a chaotic good bard who's also a Pathfinder venture caption. I think I'm remembering his class right. Anyways, the good captain's primary goal is to develop methods for treating insanity without the aid of high-level magic.
CC Book 2, set in Lepidstaht, also has an asylum, though it got destroyed because its owner got mixed in with the wrong people.
Fixing insanity is relatively expensive, and bottle necked by the number of clerics who are powerful enough to even cast the spell. And then you have to factor that those clerics often have other things that they need to do.
A cleric with mass heal would work wonders, but they're ludicrously rare and can still only help 17 to 20 people at a time.
It'd take a L20 cleric a few days to work his way through an asylum and fix everyone.
A L7 cleric is looking at anything from months to years of work based on the size of the asylum.
Are there any properly run, humane asylums that actually help their patients? I'm coming up blank there, though I'd imagine Magnimar and Absalom would be two of the more likely places to have them.Havenguard Lunatic Asylum in Caliphas (as touched upon in Rule of Fear) seems rather benevolent.Yeah, Havenguard's run by a chaotic good bard who's also a Pathfinder venture caption. I think I'm remembering his class right. Anyways, the good captain's primary goal is to develop methods for treating insanity without the aid of high-level magic.
CC Book 2, set in Lepidstaht, also has an asylum, though it got destroyed because its owner got mixed in with the wrong people.
Fixing insanity is relatively expensive, and bottle necked by the number of clerics who are powerful enough to even cast the spell. And then you have to factor that those clerics often have other things that they need to do.
A cleric with mass heal would work wonders, but they're ludicrously rare and can still only help 17 to 20 people at a time.
It'd take a L20 cleric a few days to work his way through an asylum and fix everyone.
A L7 cleric is looking at anything from months to years of work based on the size of the asylum.
... unless the clergy has been around for a few years and has had access to magic item creators. It's EXPENSIVE, no doubt, but they might have a couple staves lying around used only by the high pontiff/pontess who can then minister to the mind-sick multiple times/day.
I think that was kind of my point w/this thread: find places in Golarion willing to put in the time/effort/resources to help patients WITHOUT clerical magic. PC gets an insanity, shambles (or is forcibly escorted by party members) into a church of Saranrae, the high level priest on hand collects some coins, whips off a bippity boo and blam; crisis averted.
I'd prefer it if instead you had a place where NPCs or poorer PCs could go and try to repair their fractured minds. Asylums, convalescent homes, sanitariums, etc. And contrary to popular belief not EVERY one of them needs to feature a doktor who is using the place to experiment on their patients calling forth horrors of undeath or the great beyond. Sometimes its just a hospital where they want folks to get better.
I'll have to delve into some of these excellent sources. If you think of more info please post!
How DOES one go about treating insanity (via the Pathfinder rules system)? Is there rules for curing it? Does a Heal spell cure one particular type of madness or would you have to rely on more powerful magic (aka Miracle or Wish) for it to work?
As far as I know there aren't any particularly detailed rules available for curing insanity in Pathfinder. Greater Restoration explicitly does, as does Heal - both are referenced as useful for this purpose in RotRL.
XXX, unfortunately, remains insane. Barring a heal or greater restoration spell, he’s destined to live the rest of his short life as a madman.
It's been a while since I read the Cthulhu rules set but I seem to recall that their Insanity chapter was both comprehensive and very, very interesting to read. In Call of Cthulhu each character has a Sanity Point pool (similar to HP), whenever he'd be exposed to traumatic or particularly stressful situations he risked losing sanity points. If he lost enough sanity points he'd develop a condition, typically related to the trauma that caused the sanity point loss.
I believe it used a Heal (skill) check or a Profession: Therapist check combined with therapy sessions to restore sanity points - when the patient recuperated enough sanity points to get above the insanity threshold his condition would be removed.
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Vendor - Fantasiapelit Tampere
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In the history of horror lit, has anyone ever come back right?
Not really horror literature, but Arkham Asylum actually rehabilitated Cluemaster from his obsession of leaving clues at crime scenes. Not that he stopped being criminal, heavens no. He became even better.
I really like to add asylums and hospitals and other pretty mundane stuff in my games. Cleric's God-given powers are not to be used in vain.
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How DOES one go about treating insanity (via the Pathfinder rules system)? Is there rules for curing it? Does a Heal spell cure one particular type of madness or would you have to rely on more powerful magic (aka Miracle or Wish) for it to work?
Lesser restoration has no effect on insanity, but restoration reduces the current DC of one insanity currently affecting a target by an amount equal to the caster's level. Greater restoration, heal, limited wish, miracle, or wish immediately cures a target of all insanity.
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I believe they went into far more detail in the 'Taint of Madness' book from Chaosium, detailing the usual therapies used throughout history, and rating some of the historical sanatoriums and asylums, many of which make grim reading.
'The Unspeakable Oath' magazine from Pagan Publishing, also went into great detail, but these will be well out of print, unless they got collected into anthologies, or taken up as canon by Chaosium.
A lot of Pagan's staff seem to have been adopted by Chaosium (Den Detweiler, Jesper Myrfors off the top of my head).
To really demonstrate just how expensive a magical cure for madness costs, by first calculating for a lesser restoration spell then going from there.
Consider that a trained hireling earns, on average, 3sp per day. That's 109.5gp per year. A 2nd level spell, cast by a 3rd level caster, lesser restoration costs 2x3x10=60gp. Not that bad, right? That's assuming you only took temporary ability damage (and it would have gone away on its own!). Restoration will cost you 4x7x10=280+100 or 1,000 for material, so 380gp or 1,280gp...and doesn't do anything that should be an issue for insanity. Greater restoration is how to cure madness, but it is not cheap! 7x13x10=910+5,000 in material ends up running you 5,910gp if you can even find a cleric that experienced. If you translate the cost into years a *peasant needs to save every penny to afford it you end up with... 3/10 goes into 5,910 19,700 times, 365 goes into 19,700 (round up from 53.972) 54 times. Fifty-four years without paying rent, buying food, fixing shoes, or spending any money on anything else. Wow.
*Assuming the peasant is "trained." An untrained hireling only makes 1sp per day, so will need to save for 162 years.
Just goes to show.. High level PC's aren't just rich, they are Richard Branson "I have my own spaceship" rich. There really is a difference lol.
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And, even if you assume that NPCs use the Profession skill for income, that's (assuming they take 10, have it as a class skill, Skill Focus, one rank, and at least a +1 to Wis) still only ~9 gp a week, which is 468 a year. That's about quadruple Abyssian's number, so it'd take him *still* about 13-14 years.
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Well, let's see. The GMG suggests that madness most commonly happens when a PC/NPC suffers ability damage/drain to Int, Wis or Cha. It's not automatic; there's a chart to roll on to see if someone contracts an insanity. Initially contracting it is like a disease check in that they need to beat the insanity's DC to resist the condition. Otherwise they're suffering under madness.
Once this occurs if the afflicted doesn't have 6k in gold laying around, getting well again is a lengthy process. It involves beating the DC of the madness on a check made 1/week. If the DC is beaten that doesn't cure the patient; instead it just lowers the DC for future checks by a factor equal to the victim's Cha modifier (min 1).
So farmer Ted is attacked one day by a lamia. Instead of just eating the man this creature drains away all of his Wis for kicks. When he hits 0 the GM rolls on the chart and poor farmer Ted is afflicted with a crippling phobia for cats. This carries a DC of 14 for a Will save made every week.
Farmer Ted has a Cha of 10. Along with being a witless fool until SOMEONE takes pity on the man and cures some of his Wis he'll be wandering the countryside gibbering about evil cats while making a Will save at -5 each week. If he manages to HIT the DC or beat it, that still only reduces it by 1. At that rate farmer Ted will be afflicted with his phobia for AT LEAST 14 weeks. Harsh!
As a GM then I'd rule that non-magical curing of insanity would involve some kind of therapy using the "treat disease" function of the Heal skill. This action would grant the victim a +4 to their save. Perhaps, depending also on the conditions of the asylum there might be other bonuses/penalties to this check. In the end patients can expect to spend months if not years in one of these places before they hit a 0 DC and are considered cured.
Considering that phobias are usually things people have permanently unless treated, I'd call that remarkably lenient. YMMV.
Most of the things in the madness chart are things that don't go away naturally - the best we've ever been able to do in the real world is suppress the symptoms with medication.
Phobias are one of the few things that can actually be overcome with treatment.
Mental disorders like schizophrenia being something you can overcome with sheer force of will in the Pathfinder universe goes right in with HP and other things that require some suspension of disbelief.
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Most of the things in the madness chart are things that don't go away naturally - the best we've ever been able to do in the real world is suppress the symptoms with medication.
Phobias are one of the few things that can actually be overcome with treatment.
Which, in turn, is why asylums were, for the most part, warehouses and not particularly hospitals for treatment. Because in the real world for the vast majority of history, insanity was not treatable.
In Golarion, madness is treatable but at an absurd price. If Uncle Ernie does go mad, about the best a peasant can hope for is someplace that will keep him comfortable and out of danger. Rather like a home for the aged in that regard -- no one is expected to recover from that, either.
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Uncle Ernie? Yeah, he lives in the barn now. The OLD barn; the one on the other side of the village that no one uses any more. Probably has something to do with that one time he went out at night and was found in the morning, in the middle of a faerie ring, covered in blood and dry cider. Thing was; he didn't have a scratch on him except a lipstick kiss from tiny lips.
Oh, and then there's all the screaming...
Anyway, yes; I'd anticipate that even under these generous rules (no doubt written for PCs and not NPCs to recover from these afflictions) that asylums, sanitariums and hospitals in general in a fantasy setting are more about housing and securing the patients then actually treating them. If you want a real CURE for insanity, scrape together one-metric-ton of gold and go to the big city church; otherwise stay in your cell in the special jacket they gave you and try not to hurt your head against the bars.
Anyway, yes; I'd anticipate that even under these generous rules (no doubt written for PCs and not NPCs to recover from these afflictions) that asylums, sanitariums and hospitals in general in a fantasy setting are more about housing and securing the patients then actually treating them. If you want a real CURE for insanity, scrape together one-metric-ton of gold and go to the big city church; otherwise stay in your cell in the special jacket they gave you and try not to hurt your head against the bars.
Hospitals, not so much. I think. Cures for injury and disease are available at low levels and "reasonable" cost. If there's a cholera epidemic, for example, the DC is only 13, dropping to effectively 9 if someone provides medical attention -- a first level adept could use a mundane Healer's kit and provide literally dozens of people a day with a 50/50 shot at a cure.
That's actually substantially better than the real world can do today (50% cure rate within 24 hours?) Similarly, any injury that a first level character can walk away from will be cured completely within about four days in a Golarion hospital using only mundane means -- I've spent longer that that time myself waiting for bones to knit.
It's not a 50% cure in 24 hours, it's a 25% chance to cure in 48 hours (cure requires two consecutive saves). And failures usually inflict Con damage that lowers the save (assuming they couldn't afford to have complete bedrest to heal that up).
Running some quick numbers, it would take an average of 6 days to be cured (ignoring any degrading saves due to damage).
spoiled:It'd be darkly ironic if Korvosa was the one leading the charge in ethical mental health in the Inner Sea. ;)
Eh, they've got strong rivals over in the Stolen Lands, of all things...
:D
EDIT: for making tags work and for noting that I did so
Ummm... cholera kills by dehydration. The cholera toxins hurt the intestinal walls, spewing the patient very dry... but also washing away the cholera bacteria. Within 24 to 48 hours, it is usually over, one way or the other. There are no antibiotics that work quickly enough to matter. So... what you do is provide rehydration. If you have clean fluids for it, anyone can feed the patient a spoon every minute or so, to rehydrate them. Once the infection is over, though, it will take the patient quite a while to recover.
FYI - ran some more numbers with DC 13 (+0 save) vs. DC 13 (+4 save w/help) - Cure time halved and Mortality dropped from 7% to .12%. Pretty nice - if you have 1000 ill citizens, you saved 69 of them from death.
Ummm... cholera kills by dehydration. The cholera toxins hurt the intestinal walls, spewing the patient very dry... but also washing away the cholera bacteria. Within 24 to 48 hours, it is usually over, one way or the other. There are no antibiotics that work quickly enough to matter. So... what you do is provide rehydration. If you have clean fluids for it, anyone can feed the patient a spoon every minute or so, to rehydrate them. Once the infection is over, though, it will take the patient quite a while to recover.
So in a nutshell, your best chance of surviving Cholera is to drink a balanced but constant amount of water over a period of 48 hours? If so, thanks for letting me know. You never know when an epidemic is gonna happen. ^_~
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http://www.d20pfsrd.com/gamemastering/afflictions/diseases/cholera
Save: Fort DC 13. No multiple saves listed.
Those are some great adventure outlines!
I asked a few questions about this a while back to James Jacobs. Here's the text:
Can you use the Heal Skill to treat mental illness? (either magically induced by Insanity or otherwise) Rather, can the skill be used to aid in the weekly Will Save that a character makes to recover their mind?If not, do mental asylums in Golarion actually funtion or are they simply used to research said afflictions and not cure them?
** spoiler omitted **
If yes, would it function like an "aid another" check (requiring DC 10)or would the doctor have to beat the illness's DC in order to help?
James Jacobs:
I would say that you should and could be able to treat mental illness with skill checks, but I wouldn't make it a Heal check. I'd make it Diplomacy or maybe Sense Motive. With a DC equal to the insanity's DC, with a success granting a +4 bonus on the save (similar to how using Heal to treat poison and disease increases the next saving throw by +4).| 1 person marked this as a favorite. |
I actually just ran a madness curing session with two PCs who suffered from Insanity (MPD and Paranoia) from events experienced in Wake of the Watcher. I used a variant of the suggestion above. I had each insane PC ingest an alchemical elixir derived from Dream Spider venom which was used for the component of a Restoration spell. While this occurred, I had both PCs undergo a dream sequence where they re-enacted choices and decisions that had eventually lead them to madness. For the character with MPD who was portraying the personalities of all the slain PCs so far, it was almost like a release of guilt as he replayed different instances throughout the AP. With each sequence, I had an associated skill check that the character either wanted to succeed on to center his own personality or fail on to diverge his personality from the others he was taking on. While this was occurring, I allowed the group's Bard to utilize Perform and the Oracle to use Diplomacy to aid the insane PC on each skill check. With each check made, I lowered the DC of the illness by two, until he eventually broke the madness. The same thing occurred with the PC suffering from Paranoia, except his sequences focused on his past before the AP as well as events where the PCs were clearly helping him survive. It ran pretty awesome, which is good; it doesn't feel fair running a normal AP with PCs suffering from a -4 Will save handicap (plus other bad stuff).
d20 Ravenloft also had rules for madness and treating it with Hypnosis.
Both where recently converted to PF by Ravenloft game designer Ryan Naylor here (madness rules) and here (Hypnotism feat). These Ravenloft PF rules conversions will soon be published as a netbook btw.
You have studied the hidden workings of the mind and can unlock its secrets.
Prerequisites: Wis 13+, Cha 13+, Heal 1 rank
Benefits: You can use the Heal skill to induce hypnotic trances.
Induce trance: Inducing a trance requires 1 hour and a successful Heal check (DC 10 if willing, or opposed by the target’s Will save if they are not). Loud or distracting surroundings add a +2 circumstance penalty to the check. If the trance is induced, the target is fascinated for 2d4 rounds. The target must be able to understand you. Once in a trance, you can either implant a suggestion or attempt to cure any Madness. You cannot induce a trace in yourself.
Implant suggestion: While the subject is fascinated, it reacts as though it were two steps more friendly in attitude. This allows you to make a single request of the affected creature. The request must be brief and reasonable. Even after the spell ends, the creature retains its new attitude toward you, but only with respect to that particular request.
Cure Madness: While the subject is fascinated, you can attempt to cure any Madness they are afflicted with. They can substitute your Heal check for their Will save to attempt to overcome madness. You can use this ability once per week per patient.
Heroes in a Ravenloft campaign may find themselves facing slavering monsters that can slay with a touch, haunted by the memory of horrendous cruelty, or exposed to alien forces that can wrench their minds apart. The following rules are an optional addition to represent the effect of these terrors on PCs; if the GM thinks a player is adequately representing the hysteria that clouds the minds of characters in classic tales of horror, no dice roll is necessary.
Fear, horror and madness saves are Will saves (or sometimes Fort saves) resulting from exposure to something terrible or unnatural. They are independent of magical fear or any other game effect, so a PC attacked by a dragon must make a fear save and a save against dragonfear. They are not an action and are generally rolled as part of another activity, such as an initiative check or skill check. Characters that are immune to magical fear gain a +4 competence bonus to fear and horror saves, but are not immune to them. If the character makes the save, they are immune to that specific source of fear for 24 hours.
Generally, the DC of the save should be approximately 10 + the average party level, +2 to 4 for more horrific scenes. Remember that higher level characters have more experience than lower level characters, and so may not be afraid of the same things. Likewise, a scene of bloody slaughter is probably more confronting for a bookish wizard than a warrior, so feel free to modify the DC based on personal experience.
The effect of a failed check depends on the degree of failure and source of the emotion. In most cases, the duration should be 1 rd, or 1 encounter in severe cases.
Failure Margin Effect Examples
1-5 Minor Dazed, Sickened, Fatigued, Shaken
6-10 Moderate Stunned/Fascinated, Nauseated, Exhausted, Frightened
11-15 Major Paralyzed/Confused, Disabled, Staggered, Panicked
16+ Catastrophic As major with extended duration
In the event of a catastrophic failure, the character suffers a -4 penalty to fear and horror checks provoked by a similar event for the next month, and must make an unmodified save when confronted with things that wouldn’t normally be cause for a fear or horror save. Thus, a character who is catastrophically frightened by a werewolf may need to make a fear save whenever he approaches the site of the attack, or when he hears dogs baying at the moon, and a fear save at -4 if he sees a shapechanger transform, or is attacked again.
If a character makes another catastrophic failure within that month, they must make a Fort save at the same DC or take 3d6 temporary Constitution damage.
Madness saves should not be roleplayed; they are typically too severe. They can be instigated by complete personal tragedy, having a mental ability reduced to 0, or mental contact with an alien or insane mind (that is, someone who has failed a Madness save, a darklord, undead, outsiders, elementals, oozes, aberrations, and plants if the caster is not a druid or have access to the Plant domain). A character can also deliberately attempt to drive someone mad, by remaining in close proximity for 30 days and then making a Bluff check opposed by the victim’s Sense Motive. If the victim fails, they are driven mad; if they succeed, they can make another Sense Motive check to become aware of the failed gaslighting.
The degree of madness is modified by the degree of failure, as described above. Roll to determine the insanity that afflicts the character. Apply +25% for moderate madness, +50% for major madness, and +75% for catastrophic madness. The character also suffers 1d6 ability damage to Intelligence, Wisdom and Charisma for minor madness, 1d6 ability drain for moderate madness, and 1d10 ability drain for major or catastrophic madness.
d100 Madness Effect
1-10 Delusions/hallucinations
11-20 Depression
21-30 Nightmares
31-40 Mania
41-50 Phobia
51-60 Amnesia
61-70 Multiple Personalities
71-80 Paranoia
81-90 Psychosis
91-100 Schizophrenia
101+ Suicidal Thoughts
Amnesia (Save Will DC 20; Onset immediate; Effect –4 penalty on Will saving throws and all skill checks; loss of memory (see below))
A character suffering from amnesia cannot remember things; his name, his skills, and his past are all equal mysteries. He can build new memories, but any memories that existed before he became an amnesiac are suppressed.
Worse, the amnesiac loses all class abilities, feats, and skill ranks for as long as his amnesia lasts. He retains his base attack bonus, base saving throw bonuses, combat maneuver bonus, combat maneuver defense, total experience points, and hit dice (and hit points), but everything else is gone until the amnesia is cured. If a character gains a class level while suffering from amnesia, he may use any abilities gained by that class level normally. If the class level he gained was of a class he already possess levels in, he gains the abilities of a 1st-level character of that class, even though he is technically of a higher level in that class. If his amnesia is later cured, he regains all the full abilities of this class, including those gained from any levels taken while he was suffering from amnesia.
Delusions/Hallucinations (Save Will DC 20; Onset immediate; Effect –2 penalty on Will saving throws and all skill checks; see below)
The character either believes something about themselves that is not true (delusions) or perceives something in the world which does not exist. A deluded character can only perform actions appropriate to the delusion. If confronted with the truth, or if the player is unable to justify a deluded character’s actions, they must make a Madness save or be confused for 1d3 rounds.
A character with hallucinations must save whenever under stress or confronted with a scene reminiscent of whatever caused the original madness save. If they fail, they are subject to a phantasm with the effects of major image. The character can attempt to disbelieve as a standard action, although assurances from allies do not provide any bonus.
Depression (Save Will DC 12; Onset 1 day; Effect see below)
The character is overcome with deep melancholy. At the start of each day, the character must make a Madness save or be sickened and staggered all day. However, the character gains a +4 morale bonus to Fear and Horror saves while overcome with apathy.
Mania/Phobia (Save Will DC 14; Onset 1 day; Effect target is sickened (if manic) or shaken (if phobic) as long as the source of the mania or phobia is obvious; chance of becoming fascinated or frightened (see below))
A mania is an irrational obsession with a (usually inappropriate) particular object or situation, while a phobia is an irrational fear of a (usually commonplace) object or situation. Additionally, if a manic or phobic character is directly confronted by his obsession (requiring a standard action), he must make a Will save against the insanity or become fascinated (if manic) or frightened (if phobic) by the object for 1d6 rounds.
Multiple Personality Disorder (Save Will DC 19; Onset 2d6 days; Effect –6 penalty on Will saving throws and Wisdom-based skill checks; multiple personalities (see below))
This is a complicated disorder that manifests as 1 or more distinct and different personalities within the same body and mind. The number of additional personalities the victim manifests equals the DC of the insanity divided by 10 (round down, minimum of 1 additional personality). Should the insanity worsen in some way (such as by the save DC increasing), the number of additional personalities increases as well. Likewise, the number of additional personalities decreases as the sufferer recovers and the insanity's DC decreases. The GM should develop these additional personalities.
Every morning, and each time the afflicted character is rendered unconscious, he must make a Will save against his insanity's DC. Failure indicates that a different personality takes over. A character's memories and skills remain unchanged, but the various personalities have no knowledge of each other and will deny, often violently, that these other personalities exist.
Nightmares (Save Will DC 17; Onset Immediate; Effect see below)
Each night, the character must make a Madness save or have nightmares. The following day, the character is fatigued and cannot regain arcane spells. After a number of days of fatigue equal to 3 + their Constitution modifier, they become exhausted instead. After a similar period of time, they take 1d3 points of damage to each mental ability score until they lapse into a coma. The following night, if still unable to sleep properly, they die. Sleeping removes 2 days worth of penalties per 8 hours of sleep.
Paranoia (Save Will DC 17; Onset 2d6 days; Effect –4 penalty on Will saves and Charisma-based skill checks; cannot receive benefit from or attempt the Aid Another action; cannot willingly accept aid (including healing) from another creature unless he makes a Will save against his insanity's DC)
The paranoid character is convinced that the world and all that dwell within it are out to get him. Paranoid characters are typically argumentative or introverted.
Psychosis (Save Will DC 20; Onset 3d6 days; Effect character becomes chaotic evil; gains +10 competence bonus on Bluff checks to hide insanity)
This complex insanity fills the victim with hate for the world. He may suppress his psychosis for a period of 1 day by making a Will save against the DC of his insanity, otherwise he cannot help but plot and plan the death and destruction of his friends and enemies alike. For the most part, the impact of psychosis must be roleplayed, although not all players find entertainment in roleplaying a lunatic who's trying to do in his friends. In such cases, the GM should assume control of the character whenever his psychosis is in control.
Schizophrenia (Save Will DC 16; Onset 1d6 days; Effect –4 penalty on all Wisdom and Charisma-based skill checks; cannot take 10 or take 20; chance of becoming confused (see below))
A schizophrenic character has lost his grip on reality, and can no longer tell the difference between what is real and what is not. These constant hallucinations cause the schizophrenic to appear erratic, chaotic, and unpredictable to others. Each time a schizophrenic character finds himself in a stressful situation (such as combat) he must make a Will save against his insanity's DC. Failure indicates that the character becomes confused for 1d6 rounds.
Suicidal Thoughts (Save Will DC 18; Onset immediate; Effect As depression, plus see below)
As depression, except that should the character fail another Fear, Horror or Madness save, they must attempt to take their own life via the most efficient means possible within the next hour.
If any of a character’s mental abilities drop below 3, they become a Lost One—a walking catatonic whose mind was shattered by memories too horrible to bear. They eat and drink if fed, walk if led, and may occasionally mumble gibberish, but otherwise take no meaningful actions. They persist in this state until their madness is cured.
All insanities have a DC that represents the insanity's strength. An insanity's DC indicates the Will save you need to roll in order to resist contracting the insanity when you are initially exposed to it, but also the DC you need to make to recover. Recovering from an insanity naturally is a lengthy process—once per week, you make a Will save against the insanity's current DC. If you succeed on this save, the insanity's DC is reduced by a number of points equal to your Wisdom bonus (minimum of 1). You continue to suffer the full effects of the insanity until its DC is reduced to 0, at which point you are cured and the insanity vanishes completely. Insanity can also be cured using hypnosis; see above.
Lesser restoration has no effect on insanity, but restoration reduces the current DC of one insanity currently affecting a target by an amount equal to the caster's level. Greater restoration, heal, limited wish, miracle, or wish immediately cures a target of all insanity.