Some artifacts can also break the psyche of a character who uses or becomes attuned to them. Diseases, poisons, and planar effects such as psychic wind or the howling winds of Pandemonium can all inflict madness. Certain spells, such as contact other plane and symbol, can cause insanity, and you can use the madness rules here instead of the spell effects of those spells.
Going MadVarious magical effects can inflict madness on an otherwise stable mind. If your campaign has a strong horror theme, you might want to use madness as a way to reinforce that theme, emphasizing the extraordinarily horrific nature of the threats the adventurers face. In a typical campaign, characters aren’t driven mad by the horrors they face and the carnage they inflict day after day, but sometimes the stress of being an adventurer can be too much to bear.
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