Level 5 DiseaseCreeping Madness

The skin of the infected bubbles and shifts, causing intense pain, both physical and mental. The victim’s eyes pulse with blue fire.

Stage 0: The target recovers from the disease. Optional Rule: If the disease had progressed to stage 3 or higher, the target also gains a spellscar.
Stage 1: While affected by stage 1, the target takes a -2 penalty to initiative checks and Will. The target gains a +1 bonus to the attack rolls of powers that have the psychic keyword.
Stage 2: While affected by stage 2, the target loses one healing surge that cannot be regained until the target recovers from the disease. The target takes a -4 penalty to Perception checks and Insight checks.
Stage 3: While affected by stage 3, the target takes a -2 penalty to skill checks. The target’s attacks deal 1d6 extra psychic damage.
Stage 4: While affected by stage 4, the target descends into madness and is dazed.
Check: At the end of each extended rest, the target makes an Endurance check if it is at stage 1, 2, or 3.
9 or lower: The stage of the disease increases by one.
10-14: No Change
15 or higher: The stage of the disease decreases by one.

Published in Neverwinter Campaign Setting, page(s) 160.