What do you think this is? Diagnose Psych disorder? He is 7. He shows no empathy but hes not violent either, he has an amazing sense of entitlement and complete disregard for others, outside his family. He is affectionate with his family but doesn't care about anyone's feelings in the least. He is completely driven by his impulses 100%. Nothing violent. He is out of touch with reality for his age, lives in a fantasy world of his making. He has a twin who is much more mature and down to earth so I know how he is supposed to be. He is on meds for bipolar, they don't work, but if he don't take em he gets paranoid. Started on ADHD meds, not helping. He doesn't meet sociopath criteria, where should I be looking?

Summarized question: What is the diagnosis for someone behaving paranoid?