I have a major villain who used to be the strongest member of the party, but gained psychosis and is now under my control and gaining mass amounts of power to be used as a boss against the party soon.

I have a player playing a witch who mostly uses hexes that are listed as mind altering and attempts to cause permanent mental damage to most of the intelligent major bosses they have fought.

So my question is regarding whether the psychotic boss would take extra damage against these mind altering hexes, have resistance against them from already being in an altered state, or if the hexes should affect them as normal?

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    \$\begingroup\$ Hi. Are you using any existing mechanics for psychosis? I don't recall seeing this published by Paizo, but it's OK to use 3rd party material, you just should tell us what is it. And if it is your homebrew, what answer can we give beyond "it's your game, it's your rules, whatever you say boss"? How would you judge better answer from worse? \$\endgroup\$
    – Mołot
    Commented Oct 10, 2019 at 21:47
  • \$\begingroup\$ @Mołot d20pfsrd.com/gamemastering/other-rules/corruption gives the SRD version of the rules. Most options are from Heroes of Horror. The corruption is irrelevant, though, as presumably the GM is already dealing with that... \$\endgroup\$ Commented Oct 10, 2019 at 23:34
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    \$\begingroup\$ Welcome to RPG.SE! Take the tour if you haven't already, and check out the help center for more guidance. Could you edit your answer to address the points Mołot brings up in their comment above? \$\endgroup\$
    – V2Blast
    Commented Oct 11, 2019 at 5:05
  • \$\begingroup\$ @thedarkwanderer edit this info into your question and I'll be glad to vote reopen. \$\endgroup\$
    – Mołot
    Commented Oct 11, 2019 at 8:10
  • \$\begingroup\$ "The corruption is irrelevant," — actually it isn't, as at least one of them describes victim final stadium as mindless, and at least one does not. \$\endgroup\$
    – Mołot
    Commented Oct 12, 2019 at 23:39

1 Answer 1


The only default official form of madness in the game is the insanity spell, which is a permanent confusion effect. As confusion does not affect one’s saving throws (indeed, it does not affect any of one’s numerical modifiers), neither does insanity.

The semi-official1 variant idea for madness includes one called psychosis, which does not affect Will saves in any way (it makes the afflicted chaotic evil and gives a massive bonus on Bluff checks). Other forms of madness—amnesia, multiple personality disorder, and paranoia—do, again with similarly massive numbers (−4 for amnesia and paranoia, −6 for multiple personality disorder).

Personally, I think the madness rules are pretty poorly done. The numbers are vast, which just causes gameplay problems.2 More importantly, the effects just... don’t match what these mental disorders do to a person very well.3 They’re honestly kind of offensive, in their Hollywood-esque stereotyping. Multiple personality disorder—which is more properly known as disassociative identity disorder4—is an extreme form of a mental defense mechanism, and isn’t likely to reduce Will saves, for example. Ditto for paranoia. And what losing one’s memory has to do with making Will saves, I’ll never know, but that’s certainly not suggested by the literature. Ironically, the most often stereotyped form of mental disorder—schizophrenia—is probably the one they get most right.

That said, I’m not going to recommend anything here. Frankly, my associations and experiences with mental disorders are that they’re tragic, not epic. They’re not part of my fantasy of knights and wizards. I’d strongly advise, then, that they’re not well-handled by making rules for them—they should just be roleplayed. Don’t apply penalties, resistances, immunities, or anything else mechanical—just consider them when trying to make in-character decisions. I think you’re far less likely to cause either gameplay or social problems that way.

  1. It’s official in that Paizo printed it, but they didn’t fully detail it and it’s not an automatic part of the Pathfinder ruleset—it’s not used, for example, in Pathfinder Society play. It’s more of an idea for a GM to consider than it is a full ruleset.

  2. Note that I have worked on third-party Pathfinder products, so I do know at least a bit of what I’m talking about here.

  3. I’m not a psychologist, though I did take an abnormal psychology course in college, so I know at least a little bit. More importantly, I am married to a psychologist, who rolled her eyes at the descriptions I quoted to her.

  4. Per Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which defines these terms for the mental health industry. Note that MPD/DID is an extremely controversial item in the DSM-5, and a fairly large chunk of psychologists have doubts that it even exists. But if it does exist, it definitely doesn’t make sense to model it with a Will save penalty.

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    \$\begingroup\$ I think the corruption rules are presumably what is causing "psychosis" here-- a PC was going along and then got a big power boost and turned evil and now is the BBEG which is what that system does and is designed to do. It's at least worth a mention. Many corruptions go "You are now irredeemable crazy evil monster that just attacks everybody" at the final stage, with frequent appeals to insanity/psychosis/etc \$\endgroup\$ Commented Oct 10, 2019 at 23:40
  • \$\begingroup\$ @thedarkwanderer Why do you think so? The psychosis under the madness affliction rules causes alignment swap to CE, so it could be the rules being used—and it actually uses the name. Honestly, I strongly suspect no rules were used at all, but thought the question was kind of answerable from a “what precedent is there for mental health disorders affecting interactions with mind-affecting magic?” Something explicitly called “insanity,” “madness,” or “psychosis” seems to fit the bill for precedent; something called “corruption” doesn’t seem like it would be? \$\endgroup\$
    – KRyan
    Commented Oct 11, 2019 at 16:04
  • \$\begingroup\$ At any rate, seeing as the question is closed and the querent hasn’t bothered to come back and clarify things, I don’t really see a lot of point in augmenting it with yet another “could be what they were talking about” option. \$\endgroup\$
    – KRyan
    Commented Oct 11, 2019 at 16:05

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