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The results of general population mental health studies conducted in Guadeloupe in 2004 and 2014 reveal an excess of psychotic symptoms. We wondered about the reasons for this excess. Based on our daily experience in a psychiatric service in Guadeloupe transcribed through four clinical vignettes, and with the support of the specific literature, we have tried to interpret these figures as best we can. It seems fundamental to us to separate psychotic symptoms and schizophrenia. We came to the conclusion that this excess of psychotic symptoms was not only attributable to schizophrenic disorders, but also to an overrepresentation of psychotic symptomatology in thymic and addictive disorders in the Afro-Caribbean population. These findings should be kept in mind by the clinician in order to better understand psychotic symptomatology so as to make the most relevant therapeutic choices for the patient.