Sanity and Madness

Sanity Checks: Fundamentally, a sanity check is a Will save, with failure causing a creature to gain 1 Madness point (reading a particular mythos tome for the first time adds 1d4 Madness points on a failed check, halved (minimum 1) on a successful check). Unlike the terrified investigators in a horror themed game, heroic PCs should have some measure
of resistance to the overwhelming alien presence of eldritch mythos horrors. PCs do not have to make a Sanity check from any creature or event with a CR equal to or less than the PC’s level plus Wisdom bonus. This saves Sanity checks for only the most extreme
horrors relative to the character.

Sanity Score: Every PC has a Sanity score, which is equal to his or her level plus her lowest ability score among Intelligence, Wisdom, and Charisma. Madness Score: A character failing a sanity check gains 1 or more Madness points. For every 2 Madness points, the PC takes a -1 penalty on any skill check based on Intelligence, Wisdom, or Charisma, and to saving throws against mind-affecting effects; this penalty is doubled against effects that cause confusion or insanity (including future sanity checks) and effects with the emotion descriptor, including fear effects.
This penalty does not affect a creature’s spellcasting ability.

Mad Certainty: Madness provides a bonus rather than a penalty to Knowledge or Spellcraft skill checks made to identify or learn about creatures or spells with the mythos descriptor.

Becoming Insane: When a character’s Madness score equals or exceeds her Sanity score, she automatically becomes insane. Some mythos creatures, tomes, or spells may automatically incite a particular type of insanity; if none is specified, randomly generate a type of insanity as specified in the Pathfinder Reference Document or Gamemastery Guide.

Sanity and Madness

Shadows over Ustalav Skade