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A 67yo man with a past medical history of COPD, osteoarthritis, essential HTN, and major depressive disorder presents to the emergency department with 2 days of fever, bilateral chest discomfort, increased cough productive of green sputum, and shortness of breath. He uses a salmeterol inhaler once daily and uses a rescue inhaler of albuterol as needed, although he states that these have not been effective over the past 24hrs. He also takes amlodipine 10mg daily, fluoxetine 40mg daily, and acetaminophen 500mg twice daily as needed for joint pain. After appropriate workup, the ED physician diagnoses the patient with COPD exacerbation secondary to underlying bacterial URI. As she is giving discharge instructions to the patient, she mentions that his treatment plan will include prescriptions for cefpodoxime 200mg PO BID and prednisone 40mg PO QD. The patient expresses concern with this plan, citing a prior COPD exacerbation during which he was given a course of prednisone and subsequently developed auditory hallucinations, racing thoughts, sleeplessness, and irritability that subsided upon discontinuation of steroids. Which of the following is the most important risk factor for psychiatric side effects that the ED physician should consider when prescribing prednisone for this patient?