(CNN) -- Being the leader and second-richest person in one of the most beautiful and cultured nations on Earth might sound cushy, but Prime Minister Silvio Berlusconi is having a rough year.
Already the subject of intense criticism over his personal life and management style, Berlusconi took another blow Sunday when a man police are calling "mentally unstable" smacked the Italian prime minister in the face with a souvenir replica of a cathedral.
Berlusconi, 73, who was in his hometown of Milan stumping for a political ally, suffered broken teeth and a fractured nose. His alleged assailant, Massimo Tartaglia, is being held by Milanese authorities, who believe he acted alone.
As he has done in the past after nonphysical attacks, Berlusconi blamed political opponents.
"What I can tell you is that there has been such a buildup of hatred toward the premier, and this is not good," Berlusconi spokesman Paolo Buonaiuti said. "This campaign of hatred has been building quite rapidly recently, and I am not surprised that what happened tonight took place."
The prime minister scores highly in polls gauging Italian popular opinion, though he has been tried on various charges 17 times since taking office in 1994. The charges include corruption, false accounting and tax fraud.
Berlusconi has said he did nothing wrong and accused magistrates of conducting a witch hunt. He also noted that he has never been convicted. In some cases, he was found guilty but won on appeal.
Berlusconi was elected to his third term as premier in April 2008, about two months after his trial on corruption charges was postponed until after the election.
His ability to maneuver through political crises has prompted a prominent journalist to liken him to a puppeteer, saying he is popular because he's a skilled populist.
Berlusconi is "a man who pulls the most elementary strings of the public opinion -- a public opinion, which in Italy in these times, prefers simple paths," said Giulio Anselmi, chairman of ANSA, Italy's leading news wire.
Even by Berlusconi's standards, 2009 has been a tumultuous year, as his second wife has filed for divorce and allegations of corruption and infidelity continue to surface.
This month's Rolling Stone Italy cheekily declared him "Rock Star of the Year." Editor Carlo Antonelli released a statement saying the prime minister made rockers Keith Richards and Rod Stewart look like "schoolboys."
"This year the choice was unanimous for his obvious merits due to a lifestyle for which the words, rock 'n' roll, fall short," Antonelli's statement said.
Watch how Berlusconi was hit at a rally
The prime minister's second wife, Veronica Lario, whom he married in 1990, filed for divorce in May after news reports that he attended a birthday party for 18-year-old Neapolitan model Noemi Letizia, with whom he was accused of having an improper relationship.
Berlusconi called the allegations "slander" and the girl's family, longtime friends of the prime minister, also deny there was anything improper.
Lario, the mother of three of Berlusconi's five children, is asking for about $70 million a year from the prime minister, whom Forbes magazine ranked this year as No. 70 on its list of richest people, with an estimated net worth of $6.5 billion.
More allegations followed the divorce filing, including claims that women were paid to attend parties at the prime minister's various homes. Berlusconi denied those allegations, telling the Italian magazine "Chi" he would never pay for sex because it would dampen the "the pleasure of the conquest."
In June, he went to court to block the publication of hundreds of photos from his seaside villa in Sardinia, saying they posed "an aggressive intrusion into my private life."
A Spanish paper ran some of the photos, showing scantily clad women at Berlusconi's villa and reporting that the premier was the subject of an investigation into whether he used official Italian aircraft to ferry guests to his villa. Berlusconi admitted using government airplanes to ferry guests, but an investigation found no wrongdoing on the premier's part.
In October, old allegations of political scandal re-emerged when Italy's Constitutional Court overturned a law that shielded presidents, prime ministers and the leaders of both houses of parliament from prosecution. The court said the constitution requires all Italians to be equal before the law.
Berlusconi had pushed for the immunity law after his 2008 re-election, and the court's action opened Berlusconi to prosecution on allegations that he paid British tax attorney David Mills $600,000 to provide false testimony in two court cases in the 1990s. Mills was convicted, but is appealing.
The Constitutional Court's ruling also lifted Berlusconi's immunity from prosecution on charges that his company, Mediaset, failed to pay $45 million in taxes between 2000 and 2003.
The latter case was postponed until January because the prime minister was unable to attend hearings, but Berlusconi has been outspoken in his defense against all of the allegations.
He said he believes he is on trial for political reasons and has called magistrates "communist bullies." He also has declared himself the most persecuted man "in the entire history of the world."
The Italian leader has often blamed Italy's ills on the left wing. He doesn't enjoy leading the country, he said, "because very often there is a lot of dirty dealing." He leads out of a sense of sacrifice and duty and because he is the "only leader able to hold the center-right together," he has told CNN.
But Berlusconi seems aware that his popularity and populism allow him to continue to hold sway in this nation of about 58 million. Though his popularity recently has seen a slight dip among women, he routinely garners approval ratings of 50 percent or higher.
"When I go around, it's embarrassing to see the affection showered upon me," Berlusconi told CNN in October. "I know that people can change their opinions ... but I must say that I just note the fact that I am close to the heart of many Italians and they show this to me very often."