Create two entities: Item and Category:
<?php
namespace YourApplication\Bundle\DatabaseBundle\Entity;
use Doctrine\ORM\Mapping as ORM;
/**
 * @ORM\Entity
 * @ORM\Table(name="Categories")
 */
class Category
{
    /**
     * @ORM\Column(type="integer")
     * @ORM\Id
     * @ORM\GeneratedValue(strategy="AUTO")
     */
    protected $id;
    /**
     * @ORM\ManyToMany(targetEntity="Item", inversedBy="categories")
     * @ORM\JoinTable(name="ItemsToCategories")
     */
    protected $items;
    public function __construct() {
        $this->categories = new \Doctrine\Common\Collections\ArrayCollection();
    }
}
<?php
namespace YourApplication\Bundle\DatabaseBundle\Entity;
use Doctrine\ORM\Mapping as ORM;
/**
 * @ORM\Entity
 * @ORM\Table(name="Items")
 */
class Item
{
    /**
     * @ORM\Column(type="integer")
     * @ORM\Id
     * @ORM\GeneratedValue(strategy="AUTO")
     */
    protected $id;
    /**
     * @ORM\ManyToMany(targetEntity="Category", mappedBy="items")
     */
    protected $items;
    public function __construct() {
        $this->items = new \Doctrine\Common\Collections\ArrayCollection();
    }
}
Since a category owns the items and the items are owned by the categories, Category will be the owning side and Item will be the inverse side of the relationship.