i personally have driven in italy and other parts of europe, and its not that bad at all. just dont be a pussy. i felt more comfortable driving in italy than i do driving in the US because your completely aware and attentive the whole time cause you have to be. and so is everyone else.
but if you drive like your average american/canadian pussy driver then yes, you will have a hard time. really you just have to drive fast and aggressive as fuck, and not give a shit about pedestrians. which is the way it should be anyway.
the rest of europe is more mellow, germans are pretty crazy too. but honestly its much safer driving in these places than in the US/canada. because our driving tests are extremely easy, and for some reason its acceptable to drive around 10 under in the left lane spacing the fuck out, and our cops are dumb enough to punish the good drivers speeding instead of focusing on the people who have no clue what they are doing.
in short.. driving in italy is easy if your not a complete pussy.