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A creature struck by an effect which causes mindbreak builds up "madness". When their delirium equals or exceeds 13 + their Wisdom modifier, they experience mindbreak, which removes 20% of their maximum health all at once, become dazed for 1 round bypassing any immunities and resets their amount of mindbreak back to 0. A creature slain by mindbreak do not die, instead it stay at 0 hit point but become permanently insane as per both [[Dementia (3.5e Spell)|''dementia'']] and [[SRD:Insanity|''insanity'']]. Only [[SRD:Greater Restoration|greater restoration]] or stronger effect can cure a creature form this insanity, once cured the creature do not remember any time it spent insane mercifully.
Creature with dark insight are particularly vulnerable, just having a [[Dark Insight (3.5e Variant Rule)|dark insight]] score reduce the amount of madness needed to mindbreak by 3, and for each point of [[Dark Insight (3.5e Variant Rule)|dark insight]] the amount needed to mindbreak is reduce by 1 (to a minimum of 1). For each 3 points of dark insight a creature has it lose an additional 10% of it maximum health when it mindbreak(to a maximum of 50% at [[Dark Insight (3.5e Variant Rule)|dark insight]] 9).
Madness naturally recovers at 1 point per round for most creatures, effects which cure ability damage cure madness by an equal amount.
